Department of Radiology, Stanford University School of Medicine, Stanford, California.
Associate Chair of Quality Improvement, Department of Radiology, Stanford University School of Medicine, Stanford, California.
J Am Coll Radiol. 2020 Jul;17(7):855-864. doi: 10.1016/j.jacr.2020.05.026. Epub 2020 Jun 1.
The coronavirus disease 2019 (COVID-19) pandemic has reduced radiology volumes across the country as providers have decreased elective care to minimize the spread of infection and free up health care delivery system capacity. After the stay-at-home order was issued in our county, imaging volumes at our institution decreased to approximately 46% of baseline volumes, similar to the experience of other radiology practices. Given the substantial differences in severity and timing of the disease in different geographic regions, estimating resumption of radiology volumes will be one of the next major challenges for radiology practices. We hypothesize that there are six major variables that will likely predict radiology volumes: (1) severity of disease in the local region, including potential subsequent "waves" of infection; (2) lifting of government social distancing restrictions; (3) patient concern regarding risk of leaving home and entering imaging facilities; (4) management of pent-up demand for imaging delayed during the acute phase of the pandemic, including institutional capacity; (5) impact of the economic downturn on health insurance and ability to pay for imaging; and (6) radiology practice profile reflecting amount of elective imaging performed, including type of patients seen by the radiology practice such as emergency, inpatient, outpatient mix and subspecialty types. We encourage radiology practice leaders to use these and other relevant variables to plan for the coming weeks and to work collaboratively with local health system and governmental leaders to help ensure that needed patient care is restored as quickly as the environment will safely permit.
2019 年冠状病毒病(COVID-19)大流行导致全国范围内的放射学检查量减少,因为提供者减少了选择性护理,以最大程度地减少感染的传播并释放医疗保健提供系统的容量。在我们县发布就地避难令后,我们机构的影像学检查量减少到基线量的约 46%,与其他放射科实践的经验相似。鉴于不同地理区域疾病的严重程度和时间存在很大差异,估计放射学检查量的恢复将是放射科实践面临的下一个主要挑战之一。我们假设有六个主要变量可能会预测放射学检查量:(1)当地区域疾病的严重程度,包括潜在的后续感染“浪潮”;(2)政府取消社会隔离限制;(3)患者对离开家和进入成像设施的风险的担忧;(4)管理在大流行的急性期期间延迟的成像积压需求,包括机构容量;(5)经济衰退对健康保险和支付成像费用的能力的影响;以及(6)放射科实践的情况反映了进行的选择性成像量,包括放射科实践所看到的患者类型,如急诊,住院,门诊混合和亚专业类型。我们鼓励放射科实践的领导者使用这些和其他相关变量来计划未来几周的工作,并与当地卫生系统和政府领导人合作,以帮助确保尽快恢复所需的患者护理,只要环境安全允许。