Temporal and geographical variations of urinary tract imaging: a ten-year study from Norway

Objective Unexplained and unwarranted variations in healthcare provision are profound challenges in Scandinavian healthcare. Accordingly, the aim of this study is to investigate the temporal and geographical variations for specific procedures that are identified as a potential low-value services: urinary tract imaging. Methods Register study of outpatient and inpatient data for urinary tract imaging for Norway for the years 2013–2022. Data included patients’ age, examination code, examination name, modality, hospital/imaging centre, and inpatient/outpatient status. Results 747,969 urinary tract image examinations are performed in Norway over a period of 10 years, amounting 142 examinations per 10,000 persons per year with an Interquartile Range (IQR) of 20. The median number of age- and sex-adjusted examinations of CT of the urinary tract was 71 examinations per 10,000 inhabitants per year, and IQR was 10, while the median number of examinations varied between 52 and 83 while the IQR varied between 21 and 41 between the various hospital trusts. Conclusions This is the first study of the extent and variation of imaging of the urinary tract from a whole nation for as long as ten years. It documents substantial geographical and temporal variations that are difficult to explain demographically. Knowledge of such variations is crucial for the assessment of the equity of care and for tailoring the efforts to improve the quality, safety, and efficiency of imaging services.