Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
Clin Imaging. 2021 Dec;80:77-82. doi: 10.1016/j.clinimag.2021.06.003. Epub 2021 Jun 7.
COVID-19 has resulted in decreases in absolute imaging volumes, however imaging utilization on a per-patient basis has not been reported. Here we compare per-patient imaging utilization, characterized by imaging studies and work relative value units (wRVUs), in an emergency department (ED) during a COVID-19 surge to the same period in 2019.
This retrospective study included patients presenting to the ED from April 1-May 1, 2020 and 2019. Patients were stratified into three primary subgroups: all patients (n = 9580, n = 5686), patients presenting with respiratory complaints (n = 1373, n = 2193), and patients presenting without respiratory complaints (n = 8207, n = 3493). The primary outcome was imaging studies/patient and wRVU/patient. Secondary analysis was by disposition and COVID status. Comparisons were via the Wilcoxon rank-sum or Chi-squared tests.
The total patients, imaging exams, and wRVUs during the 2020 and 2019 periods were 5686 and 9580 (-41%), 6624 and 8765 (-24%), and 4988 and 7818 (-36%), respectively, and the percentage patients receiving any imaging was 67% and 51%, respectively (p < .0001). In 2020 there was a 170% relative increase in patients presenting with respiratory complaints. In 2020, patients without respiratory complaints generated 24% more wRVU/patient (p < .0001) and 33% more studies/patient (p < .0001), highlighted by 38% more CTs/patient.
We report increased per-patient imaging utilization in an emergency department during COVID-19, particularly in patients without respiratory complaints.
COVID-19 导致绝对影像学检查量减少，但尚未报道每例患者的影像学利用情况。在这里，我们比较了 COVID-19 疫情期间和 2019 年同期急诊科每例患者的影像学利用情况，通过影像学检查和工作相对价值单位（wRVU）来衡量。
这项回顾性研究纳入了 2020 年 4 月 1 日至 5 月 1 日和 2019 年同期在急诊科就诊的患者。患者分为三个主要亚组：所有患者（n=9580，n=5686）、有呼吸系统症状的患者（n=1373，n=2193）和无呼吸系统症状的患者（n=8207，n=3493）。主要结局为每位患者的影像学检查次数和 wRVU。次要分析根据处置方式和 COVID 状态进行。比较采用 Wilcoxon 秩和检验或卡方检验。
2020 年和 2019 年期间的总患者数、影像学检查次数和 wRVU 分别为 5686 和 9580（-41%）、6624 和 8765（-24%）和 4988 和 7818（-36%），接受任何影像学检查的患者比例分别为 67%和 51%（p<0.0001）。2020 年有呼吸系统症状的患者就诊人数相对增加了 170%。2020 年，无呼吸系统症状的患者 wRVU 增加了 24%（p<0.0001），影像学检查增加了 33%（p<0.0001），其中 CT 检查增加了 38%。
我们报告了 COVID-19 期间急诊科每例患者的影像学利用增加，特别是在无呼吸系统症状的患者中。
