Medical Technology, Health Information and Research Directorate, Ministry of Health, Jerusalem, Israel.
The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100, Ramat-Gan, Israel.
Isr J Health Policy Res. 2021 Jul 15;10(1):40. doi: 10.1186/s13584-021-00472-y.
Marked reductions in imaging exams have been documented during the COVID-19 pandemic. The study aimed to examine the effect of the two waves of COVID-19 on magnetic resonance imaging (MRI) utilization at the national and regional level.
A retrospective-archive study was conducted in Israel, comparing March-December 2020 with March-December 2018 and 2019. Data on MRI utilization were obtained from the national MRI registry, while data on confirmed COVID-19 cases, by place of residence, were obtained from the Israeli Ministry of Health open COVID-19 database.
The number and rate of MRI examinations decreased during the first COVID-19 wave, with the steepest drop in April 2020: 47.5% relative decrease compared to April 2019, and 42.2% compared to 2018. This was followed by a compensatory increase between the waves and a return to almost pre-pandemic levels of use, with just a modest decrease, during the second, more intense COVID wave, compared with the previous year. Existing differences between regions increased during the pandemic. The rate ratio of MRI exams between Tel-Aviv and the Northern periphery increased from 2.89 in April 2019 to 3.94 in April 2020. Jerusalem metropolitan region, with the largest burden of COVID disease, demonstrated only a modest decrease (1%) in MRI utilization during the first 10 months of the pandemic.
At the national level, time trends in reduced MRI utilization followed the first wave of COVID-19, and were accompanied by increased regional disparities. These changes were not explained by differences in the burden of COVID-19 disease but might be explained by unequal distribution of MRI scanners among regions. Reduced utilization was not evident during the second wave, nor at the beginning of the third wave, despite higher COVID-19 case load, demonstrating adaptation to the new normal. Patterns of MRI utilization might help policy-makers and healthcare managers predict the behavior of imaging as well as other sectors, such as elective surgical procedures, during an ongoing pandemic. This forecast might help to manage the lasting effects of the pandemic, including extended waiting times, in the months and years following its remission. In preparation for future national emergencies, timely and detailed data on MRI utilization can serve as a "sensor" for a wide array of diagnostic and interventional medical activities, providing policy-makers with an updated snapshot to guide their response at the regional and national levels.
在 COVID-19 大流行期间，影像学检查的数量明显减少。本研究旨在检查 COVID-19 的两波疫情对国家和地区层面磁共振成像（MRI）利用率的影响。
本研究在以色列进行了一项回顾性档案研究，将 2020 年 3 月至 12 月与 2018 年和 2019 年同期进行了比较。MRI 利用率数据来自国家 MRI 注册处，而按居住地获得的 COVID-19 确诊病例数据则来自以色列卫生部开放的 COVID-19 数据库。
在第一波 COVID-19 疫情期间，MRI 检查数量和比率下降，2020 年 4 月降幅最大：与 2019 年 4 月相比，下降了 47.5%，与 2018 年相比，下降了 42.2%。随后，在两波疫情之间出现了补偿性增加，并恢复到几乎接近大流行前的使用水平，与前一年相比，第二波疫情期间的使用量仅略有下降，且更为强烈。大流行期间，各地区之间的现有差异有所增加。特拉维夫和北部边缘地区的 MRI 检查率比值从 2019 年 4 月的 2.89 上升至 2020 年 4 月的 3.94。耶路撒冷大都市区是 COVID 疾病负担最大的地区，在大流行的前 10 个月内，MRI 利用率仅略有下降（1%）。
在国家层面，MRI 利用率下降的时间趋势与 COVID-19 第一波疫情相符，同时还伴有区域差异的增加。这些变化不能用 COVID-19 疾病负担的差异来解释，但可能是由于各地区之间 MRI 扫描仪的分布不均造成的。尽管 COVID-19 病例数增加，但在第二波疫情期间和第三波疫情开始时，利用率并未明显下降，表明已经适应了新常态。MRI 利用率模式可以帮助决策者和医疗保健管理人员预测影像学以及其他领域（如选择性手术）的行为，包括在大流行持续期间。这种预测可能有助于在大流行消退后的数月和数年中管理其持续影响，包括延长的等待时间。为了应对未来的国家紧急情况，及时、详细的 MRI 利用率数据可以作为广泛的诊断和介入医疗活动的“传感器”，为决策者提供更新的快照，以指导他们在地区和国家层面做出反应。
