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Gus Iversen, Editor in Chief | January 23, 2026
Children treated at non-children’s hospitals are more likely to receive imaging involving ionizing radiation compared to those treated at children’s hospitals, according to a new study from the Harvey L. Neiman Health Policy Institute and the American College of Radiology’s Pediatric Imaging Research Committee.
Published in the
Journal of the American College of Radiology, the study analyzed more than 5.4 million outpatient hospital encounters for pediatric Medicaid patients from 2018 and 2019. Researchers found that CT and radiography, both of which involve ionizing radiation, were used more frequently at non-children’s hospitals. In contrast, children’s hospitals relied more on MR and ultrasound, which do not involve ionizing radiation.
Non-children’s hospitals used CT in 1.0% of encounters compared to 0.5% at children’s hospitals. Radiography was used in 11.8% of visits at non-children’s facilities versus 7.5% at children’s hospitals. Meanwhile, MR and ultrasound were more commonly used at children’s hospitals; 0.9% and 2.5% of encounters, respectively, compared to 0.5% and 1.7% at non-children’s facilities.
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“The data show clear, measurable variation in imaging practices between children’s and non-children’s hospitals,” said Casey Pelzl, lead author and principal economics and health services researcher at the Neiman Institute. “Even after accounting for factors like patient complexity and chief complaint, CT and radiography were used more often at non-children’s hospitals.”
Of the total encounters studied, 53% occurred at children’s hospitals, defined as facilities primarily serving pediatric populations or those with designated pediatric units, while the remaining 47% took place at hospitals with limited or no pediatric services.
“Children are not just small adults, and the imaging used in their diagnoses should reflect children’s higher sensitivity to ionizing radiation,” said Dr. Sherwin Chan, vice chair of radiology research at Children’s Mercy Kansas City.
The study underscores the need for broader adoption of pediatric-specific imaging protocols, particularly at facilities lacking dedicated pediatric radiology infrastructure.
