Mobile radiography services in nursing homes: a systematic review of residents’ and societal outcomes

Abstract

BackgroundDemographic changes are leading to an ageing population in Europe, and predict an increase in the number of nursing home residents over the next 30 years. Nursing home residents need specialised healthcare services such as radiology due to both chronic and acute illnesses. Mobile radiography, x-ray examinations performed in the nursing homes, may be a good way of providing services to this population. The aim of this systematic review was to identify the outcomes of mobile radiography services for nursing home residents and society.MethodsA systematic review based on searches in the Medline, Cochrane, PubMed, Embase and Svemed + databases was performed. Titles and abstracts were screened according to a predefined set of inclusion criteria: empirical studies in the geriatric population, and reports of mobile radiography services in a clinical setting. All publications were quality appraised using MMAT or CASP appraisal tools. Data were extracted using a summary table and results were narratively synthesised.ResultsTen publications were included. Three overarching outcomes were identified: 1) reduced number of hospitalisations and outpatient examinations or treatments, 2) reduced number of transfers between nursing homes and hospitals and 3) increased access to x-ray examinations. These outcomes were interlinked with the more specific outcomes for residents and society reported in the literature. For residents there was a reduction in burdensome transfers and waiting time and adequate treatment and care increased. For society, released resources could be used more efficiently, and overall costs were reduced substantially.ConclusionsThis review indicates that mobile radiography services for nursing home residents in the western world are of comparable quality to hospital-based examinations and have clear potential benefits. Mobile radiography reduced transfers to and from hospital, increased the number of examinations carried out and facilitated timely diagnosis and access to treatments. Further research is needed to formally evaluate potential improvements in care quality and cost-effectiveness.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2173-8) contains supplementary material, which is available to authorized users.

Cost analysis of mobile radiography services for nursing home residents in Southeast Norway

“…However, earlier research has shown that mobile radiography services facilitate high-quality treatment and care. 16 According to Ranhoff and Linnsund, 6 nursing home residents would in most cases be better off treated in the nursing home. Providing adequate treatment in nursing homes would, in many cases, be easier when the diagnosis is supported by imaging.…”

“…7,9,10,23 Treatment in the nursing home would be the best alternative for most residents because of their poor health and need for a calm and familiar environment. 6,14,16…”

“…According to previous research, a mobile radiography service may reduce the number of hospitalizations and reduce the number of residents that develop delirium. 16 The imaging department at the hospital is responsible for the investment costs of a mobile radiography service (a vehicle, X-ray equipment, and operation costs). The benefits that are gained from less transportation and hospitalization occur in the other departments or institutions.…”

“…The benefits that are gained from less transportation and hospitalization occur in the other departments or institutions. [16][17][18][19] There is a relatively small body of literature concerning the costs of mobile radiography services. Three publications from Norway and Sweden have compared the cost of examining residents using a mobile radiography service with the cost of outpatient examinations in hospital.…”

“…The remaining hospitals in the region have hospital-based imaging only. 16 The mobile radiography services cover 33 out of 75 municipalities in the region. More details on the demographics of the region are presented in Table 1.…”