Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
Acad Radiol. 2020 Sep;27(9):1204-1213. doi: 10.1016/j.acra.2020.06.024. Epub 2020 Jul 7.
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.
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.
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.
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.
预测模型和传闻文章表明，在 COVID-19 大流行期间，放射科的常规影像学检查量减少了 50%-70%。本研究使用实际的机构数据，旨在调查公共卫生危机期间影像学检查的使用量和收入变化情况。
在 2020 年 3 月 8 日至 4 月 30 日的 8 周内进行的影像学检查被分为 COVID-19 医疗保健危机时间段。该日期范围的第一周和之前的 10 周用于得出常规实践的预期检查量。使用滚动 7 天的总数值进行体积跟踪和比较。通过患者就诊地点（门诊、住院、急诊）和影像学方式（X 射线、CT、乳腺 X 线摄影术、MRI、核医学/PET、超声）对总成像利用率进行了推导和分类。对三个检查量最高的医院进行了分析。从医院计费系统收集了收入信息。
2020 年 4 月 7 日至 13 日期间，系统范围的影像学检查量下降了 55%。与常规实践相比，门诊检查减少了 68%。急诊检查减少了 48%，住院检查减少了 31%。乳腺 X 线摄影术和核医学扫描受影响最大，分别减少了 93%和 61%。与其他较小的、以门诊为导向的医院相比，主院区医院的相对影像学检查量损失较少。在最低点，主院区影像学服务的技术组件收入与常规实践相比表现出 49%的负方差。
呈现的实际影像学使用数据的趋势和幅度将有助于为更准确的预测、政策变化以及当前和未来大流行期间的机构准备提供循证决策。
