Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029.
Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029.
Acad Radiol. 2021 Apr;28(4):447-456. doi: 10.1016/j.acra.2021.01.015. Epub 2021 Jan 18.
This study seeks to quantify the financial impact of COVID-19 on radiology departments, and to describe the structure of both volume and revenue recovery.
Radiology studies from a large academic health system were retrospectively studied from the first 33 weeks of 2020. Volume and work relative value unit (wRVU) data were aggregated on a weekly basis for three periods: Presurge (weeks 1-9), surge (10-19), and recovery (20-33), and analyzed compared to the pre-COVID baseline stratified by modality, specialty, patient service location, and facility type. Mean and median wRVU per study were used as a surrogate for case complexity.
During the pandemic surge, case volumes fell 57%, while wRVUs fell by 69% relative to the pre-COVID-19 baseline. Mean wRVU per study was 1.13 in the presurge period, 1.03 during the surge, and 1.19 in the recovery. Categories with the greatest mean complexity declines were radiography (-14.7%), cardiothoracic imaging (-16.2%), and community hospitals overall (-15.9%). Breast imaging (+6.5%), interventional (+5.5%), and outpatient (+12.1%) complexity increased. During the recovery, significant increases in complexity were seen in cardiothoracic (0.46 to 0.49), abdominal (1.80 to 1.91), and neuroradiology (2.46 to 2.56) at stand-alone outpatient centers with similar changes at community hospitals. At academic hospitals, only breast imaging complexity remained elevated (1.32 from 1.17) during the recovery.
Reliance on volume alone underestimates the financial impact of the COVID-19 pandemic as there was a disproportionate loss in high-RVU studies. However, increased complexity of outpatient cases has stabilized overall losses during the recovery.
本研究旨在量化 COVID-19 对放射科的财务影响，并描述其工作量和收入恢复的结构。
回顾性分析了一家大型学术医疗系统 2020 年前 33 周的放射学研究。按周汇总了三个时期（预激增期[第 1-9 周]、激增期[第 10-19 周]和恢复期[第 20-33 周]）的工作量和工作相对价值单位（wRVU）数据，并按检查类型、专业、患者服务地点和医疗机构类型进行分层，与 COVID-19 前基线进行比较。每个研究的平均和中位数 wRVU 用作病例复杂性的替代指标。
在疫情高峰期，工作量下降了 57%，而与 COVID-19 前基线相比，wRVU 下降了 69%。预激增期的平均 wRVU 为每个研究 1.13，激增期为 1.03，恢复期为 1.19。平均复杂性降幅最大的类别是放射摄影（-14.7%）、心胸成像（-16.2%）和社区医院整体（-15.9%）。乳腺成像（+6.5%）、介入（+5.5%）和门诊（+12.1%）的复杂性增加。在恢复期，独立门诊中心的心胸（从 0.46 增至 0.49）、腹部（从 1.80 增至 1.91）和神经放射学（从 2.46 增至 2.56）的复杂性显著增加，社区医院也有类似的变化。在学术医院，只有乳腺成像的复杂性在恢复期仍保持升高（从 1.17 增至 1.32）。
仅依赖工作量会低估 COVID-19 大流行的财务影响，因为高 RVU 研究的损失不成比例。然而，在恢复期，门诊病例复杂性的增加稳定了整体损失。
