Families report financial strain from pediatric imaging

Nearly half of families whose children underwent outpatient imaging reported high financial toxicity, according to a study published in Academic Radiology. A summary of the study reported that 49% of caregivers scored below the high-burden threshold on an adapted FACIT-COST instrument.

Shireen Hayatghaibi, PhD, of Cincinnati Children’s Hospital, and colleagues surveyed 399 parents and guardians at 2 freestanding pediatric hospitals between July 2024 and May 2025. The mean financial toxicity score was 24.6 out of 44, with lower scores indicating greater financial strain.

Overall, 6.7% of families said they had previously delayed or skipped their child’s imaging because of cost. Among families with high financial toxicity, that rate was 10.6%, compared with 3% among families with lower financial burden.

Advanced imaging was associated with higher financial strain. Children receiving CT, MRI, or multimodality imaging had 80% higher adjusted odds of their families experiencing high financial toxicity compared with children receiving X-rays, ultrasound, or fluoroscopy.

Household income was a major predictor. Families earning less than $25,000 had nearly 5 times the odds of high financial toxicity compared with families earning more than $100,000, while those earning $25,000 to $50,000 had nearly 7 times the odds.

Parental education also showed an association. Caregivers with some college or vocational training had more than 2 times the odds of high financial toxicity compared with college graduates.

Study authors said radiology departments are positioned to screen for financial hardship, but screening should be paired with support services such as financial navigation programs and institutional charity care.