Does on‐site computed tomography matter? A cross‐sectional study of stroke patients’ door‐to‐scan‐time in rural hospitals

Abstract

AbstractPurposeMany rural Australian hospitals lack on‐site computed tomography (CT). These hospitals often refer patients to local off‐site private radiology clinics or to central hospitals, challenging the achievement of time‐sensitive scans. For stroke patients, timely access to CT affects treatment options. This study questions whether on‐site CT matters in rural hospitals by investigating stroke patients’ door‐to‐scan‐time (DTST) and CT scan sequence referrals.MethodA retrospective chart audit was completed across four rural hospitals; two with on‐site CT and two without. Adult emergency stroke presentations were randomly sampled. Comparisons between on‐site and off‐site CT hospitals were made for DTST and CT sequence referrals using Mann–Whitney U‐tests and Fisher's exact tests.ResultsA total of 120 charts were audited (on‐site CT, n = 60; off‐site CT, n = 60). DTST was longer for off‐site vs. on‐site CT hospitals (median = 4.30 h vs. median = 0.70 h; U = 338, p < 0.001) regardless of whether presentations occurred in business hours or out of hours (p < 0.001). Off‐site CT hospitals ordered less CT angiography or perfusion scanning (32% vs. 85%, p < 0.001).ConclusionsOff‐site CT hospital patients had longer DTST and received less angiography or perfusion scanning. These findings suggest that on‐site CT matters to rural stroke patients by improving equitable access to CT and appropriate scan referrals.