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APHA Scientific Session and Event Listing

Jonathan Sunshine, PhD, Research, American College of Radiology, 1891 Preston White Drive, Reston, VA 20191, 703-648-4923, cmeghea@acr.org

Medical imaging is one of the fastest-growing components of healthcare, and rapidly-increasing overall healthcare costs are again making headlines. However, imaging has been very little studied from a health research services perspective. We propose a panel devoted to medical imaging consisting of three papers.

The first paper (Dynamics and Causes of Medical Imaging's Extraordinarily Rapid Growth, presenter Jonathan Sunshine) identifies the patterns in the growth of imaging, doing so in a way that contributes to understanding their causes and possible remedies. The results of the first paper have important implications for utilization management and for the nature of appropriateness criteria.

Increased utilization of imaging can have benefits. Increased use of mammography screening has been clearly shown to have a sizeable contribution to recent reductions in breast cancer mortality. However, there remain variations in breast cancer mortality rates by race and ethnicity. The objective of the second paper (Racial and ethnic disparities in mammography screening over the period 1996 – 2003, presenter Cristian Meghea) is to measure racial and ethnic disparities in mammography screening in 2003 and trends over time since 1996. The study finds some disparities clearly remain and analyzes their sources.

Disparities in health care outside of imaging have been extensively documented, but causes and potential remedies for disparities have been little explored in any field. The third paper (Location decisions of mammography facilities: racial/ethnic disparities across zip-codes, presenter Mythreyi Bhargavan) explores one possibly major and remediable cause of disparities—namely, facilities may disproportionately fail to locate in minority neighborhoods and/or facilities in these communities may have relatively low commitment to patient service. The study finds that zip codes with high percentages of blacks or Hispanics are much less likely to have a mammography facility than predominantly white zip-codes, and explores the extent to which this is explicable by factors such as socio-economic characteristics of the neighborhoods.

Learning Objectives: