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Showing content from https://pubmed.ncbi.nlm.nih.gov/32665091/ below:

COVID-19 Pandemic Impact on Decreased Imaging Utilization: A Single Institutional Experience

. 2020 Sep;27(9):1204-1213. doi: 10.1016/j.acra.2020.06.024. Epub 2020 Jul 7. COVID-19 Pandemic Impact on Decreased Imaging Utilization: A Single Institutional Experience

Affiliations

¹ Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106. Electronic address: Keval.Parikh@UHhospitals.org.
² Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.

PMID: 32665091
PMCID: PMC7340053
DOI: 10.1016/j.acra.2020.06.024

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COVID-19 Pandemic Impact on Decreased Imaging Utilization: A Single Institutional Experience

Keval D Parikh et al. Acad Radiol. 2020 Sep.

. 2020 Sep;27(9):1204-1213. doi: 10.1016/j.acra.2020.06.024. Epub 2020 Jul 7. Affiliations

¹ Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106. Electronic address: Keval.Parikh@UHhospitals.org.
² Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.

PMID: 32665091
PMCID: PMC7340053
DOI: 10.1016/j.acra.2020.06.024

Item in Clipboard

Abstract

Rationale and objectives: Predictive models and anecdotal articles suggest radiology practices were losing 50%-70% of their normal imaging volume during the COVID-19 pandemic. Using actual institutional data, we investigated the change in imaging utilization and revenue during this public health crisis.

Materials and methods: Imaging performed within the 8-week span between March 8 and April 30, 2020 was categorized into the COVID-19 healthcare crisis timeframe. The first week of this date range and the 10 weeks prior were used to derive the normal practice expected volume. A rolling 7-day total value was used for volume tracking and comparison. Total imaging utilization was derived and organized by patient setting (outpatient, inpatient, emergency) and imaging modality (X-ray, CT, Mammography, MRI, Nuclear Medicine/PET, US). The three highest volume hospitals were analyzed. Revenue information was collected from the hospital billing system.

Results: System-wide imaging volume decreased by 55% between April 7 and 13, 2020. Outpatient exams decreased by 68% relative to normal practice. Emergency exams decreased by 48% and inpatient exams declined by 31%. Mammograms and nuclear medicine scans were the most affected modalities, decreasing by 93% and 61%, respectively. The main campus hospital experienced less relative imaging volume loss compared to the other smaller and outpatient-driven hospitals. At its lowest point, the technical component revenue from main campus imaging services demonstrated a 49% negative variance from normal practice.

Conclusion: The trends and magnitude of the actual imaging utilization data presented will help inform evidence-based decisions for more accurate volume predictions, policy changes, and institutional preparedness for current and future pandemics.

Keywords: COVID-19; Imaging Utilization; Multimodality.

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Figures
Figure 1

The rolling 7-day total number…

Figure 1

The rolling 7-day total number of imaging exams performed in the Northeast Ohio…

Figure 1

The rolling 7-day total number of imaging exams performed in the Northeast Ohio healthcare institution between February 3, 2020 and April 30, 2020. The dashed horizontal line represents the normalized/average number of total exams performed over a 7-day period between February 3, 2020 and March 14, 2020. The rolling 7-day total of new COVID cases in the State of Ohio is also shown.

Figure 2

The rolling 7-day total number…

Figure 2

The rolling 7-day total number of imaging exams performed cumulatively in the Northeast…

Figure 2

The rolling 7-day total number of imaging exams performed cumulatively in the Northeast Ohio health system between February 3, 2019 and April 30, 2019 (a) cumulatively, and (b) by each patient setting of ED, inpatient, and outpatient. The dashed horizontal line represents the normalized/average number of total exams performed over a 7-day period between February 3, 2019 and March 14, 2019.

Figure 3

The rolling 7-day total number…

Figure 3

The rolling 7-day total number of imaging exams performed in each patient setting…

Figure 3

The rolling 7-day total number of imaging exams performed in each patient setting of ED, inpatient, and outpatient. The dashed horizontal lines represent the normalized/average number of total exams performed over a 7-day period for each patient setting.

Figure 4

The 7-day total number of…

Figure 4

The 7-day total number of radiology exams performed in the health system broken…

Figure 4

The 7-day total number of radiology exams performed in the health system broken down by the selected modalities of plain films, CT, mammograms, MRI, Nuclear Medicine (including PET) and Ultrasound. The modality proportions and total volume change is seen chronologically between March 8 and April 26.

Figure 5

The three largest hospitals in…

Figure 5

The three largest hospitals in the healthcare institution. (a) The rolling 7-day total…

Figure 5

The three largest hospitals in the healthcare institution. (a) The rolling 7-day total number of imaging exams performed in each hospital is shown. (b–d) The Central, East, and West hospital imaging volumes are further separated by the three major patient settings, respectively.

Figure 5

The three largest hospitals in…

Figure 5

The three largest hospitals in the healthcare institution. (a) The rolling 7-day total…

Figure 5

Figure 6

The percent variance of the…

Figure 6

The percent variance of the technical component of hospital revenues. Data are based…

Figure 6

The percent variance of the technical component of hospital revenues. Data are based on a rolling 7-day actual total that is compared to the 7-day normalized projected total for 2020.