RURAL RADIOLOGY - WHO IS PRODUCING IMAGES AND WHO IS READING THEM

The purpose of this study is to identify the local availability and tr ends in local availability of imaging technology and interpretation se rvices in rural hospitals in the northwestern United States during the period between 1991 to 1994. Another objective is to describe hospita l and community factors associated with the diffusion of image product ion and interpretation services. The information for this study was ga thered through telephone surveys of rural hospital administrators in e ight northwestern states in 1991 and 1994. The availability of magneti c resonance imaging (MRI) equipment, computed tomography (CT) scanners , ultrasonography equipment, and dedicated mammography equipment incre ased between 1991 and 1994. The increases in MRI units were primarily in mobile equipment, while ultrasonography and mammography equipment i ncreases were primarily fixed hospital-based units. In 1994, image int erpretation in the rural hospitals was provided by both primary care a nd radiology physicians. Forty-six (11.5%) of the rural hospitals had no on-site radiology services and only 73 (18%) had daily radiology se rvices. Between 1991 and 1994, 12 hospitals gained at least once-a-wee k radiology services, but 24 lost all radiology services. Teleradiolog y availability more than doubled during the three years. Radiologic te chnology has diffused widely into rural communities in this region of the United States at differing rates for large and small hospitals. Ra diologists are available to these hospitals only 46 percent of the day s each year, with more days of availability in the larger hospitals an d fewer days in the smaller hospitals. Teleradiology capability is inc reasing more rapidly in the larger hospitals that hn-Je radiologists m ore readily available.