According to the European Union demography report [
1] an increase in the old age population is expected over the few next decades, which may lead to an increase in people living in healthcare institutions [
1,
2]. Demographic changes in the Western world makes high-quality and cost-effective services an important factor in order to maintain sustainable healthcare systems [
3,
4]. In 2015, 42,644 people resided in care institutions for the elderly in Norway, including both long- and short-term stays. Residents in different types of care institutions in Norway, hereafter called nursing homes, have a mean age of 82.3 years [
5]. These residents have a greater need for specialised healthcare services compared to the rest of the population. This is due to the fact that up to 80% are living with dementia and/or several co-morbidities and high incidence of acute illness and injuries [
6‐
11]. According to Graverholt et al. [
8], 16–62% of nursing home residents are admitted to a hospital for acute care every year, of which up to 40% could be avoided. Admittance to hospital is associated with complications for nursing homes residents, thus treatment in the nursing home is preferable [
6,
7]. Nursing home residents can be admitted to a hospital for three reasons: diagnostic, treatment to improve function and life expectancy, or palliative treatment [
6]. In 2013, the most common reasons for acute admittance of nursing home residents in a Norwegian setting were diseases of the respiratory system (19.8%), injury, poisoning, and certain other consequences of external causes (mostly fall injuries and hip fractures) (17.8%), diseases of the circulatory system (16.5%), and diseases of the digestive system (9.9%) [
8]. According to Ranhoff and Linnsund [
6], there are two cases where hospitalisation benefits most nursing home residents: hip fractures and severe anaemia. Otherwise, the benefit of admittance depends on the residents’ condition and most would be better off treated in the nursing home [
6]. According to Wang et al. [
12], approximately 72% of nursing home residents visiting an emergency department in the USA needed diagnostic imaging; of these, approximately 85% needed X-ray examinations and 35% needed CT scans. In Oslo in 2004 during a period of 8 weeks 51% of health incidents in nursing homes included diagnostic imaging, a proportion of about 0.5 examination per person per year [
13]. 90% of these examinations were plain radiography, 4% were CT of the head, 4% fluoroscopy and 2% ultrasound [
13]. Diagnostic imaging provide evidence that adds to treatment or care of nursing home residents. Most examinations of nursing home residents are performed in question of fractures and increased dyspnoea [
11,
14,
15]. According to several studies from Norway and Sweden 29–85% of diagnostic imaging procedures affected the treatment and/or care of the resident, by either confirming or disconfirming the suspected diagnosis, provide evidence for unknown pathology or provide status for follow-up purposes [
13‐
15]. Not having access to diagnostic imaging could thus result in inaccurate treatment, pain, and reduced life quality for these residents [
6,
7,
11].
In the general population, international trends in diagnostic imaging show a decrease in the use of plain radiographs and fluoroscopy and an increase in the use of CT and MRI [
16‐
21]. However, for nursing home residents, plain radiography seem to be the most important imaging test [
12,
13,
22]. Furthermore, Lærum, Åmdal [
11] indicated an underuse of diagnostic imaging for nursing home residents compared to the general population. This is quite the opposite of expectations based on nursing home residents’ health status [
11]. The reason for this underuse may be that some residents are in no condition to travel to the imaging department or there is a lack of personnel to accompany residents [
13,
14], thus inferior access to imaging. Earlier research showed that access to imaging services influenced the utilisation rate [
23,
24].
To improve access, a mobile radiography service to nursing homes was piloted in Oslo in 2004 [
11]. In this service, a radiographer brought a portable X-ray machine and conducted plain radiographs (skeletal, chest or abdominal images) in the residents’ rooms [
25]. At present, such services operate in Australia, Italy, Norway, Sweden, and Switzerland [
22,
25‐
29]. According to earlier research, mobile radiography is beneficial for nursing home residents with a reduction in onset delirium, fewer hospital admittances and more adequate treatment, further mobile radiography services reduce societal and healthcare costs [
14,
25,
30,
31].