COVID-19 Pandemic Impact on Decreased Imaging Utilization: A Single Institutional Experience

Abstract

Rationale and Objectives: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.

Imaging Volume Trends and Recovery During the COVID-19 Pandemic: A Comparative Analysis Between a Large Urban Academic Hospital and Its Affiliated Imaging Centers

“…Naidich et al recently reported a decrease in imaging volume by as much as 88% at Northwell Health (11). In addition, outpatient imaging volume was shown to be disproportionately affected compared to inpatient volume due to postponement of elective patient visits and surgeries (12). Although affiliated imaging centers play an important role in the operation of numerous healthcare systems, little is known of how their operations are impacted by the COVID-19 pandemic.…”

Interventional radiology procedural volume changes during COVID-19 initial phase: A tertiary level Midwest health system experience

“…9,10 Outpatient volumes also have a larger impact on overall revenue for a hospital system with recent literature demonstrating a nearly 50% revenue loss for a large Midwest health system during the initial 8 weeks of the COVID-19 health crisis. 11 A large hospital system in Boston observed a 57% decrease in their hospital procedural volume and a 45% decrease in their outpatient volume when compared to 2019. Interestingly, their off campus outpatient IR suite showed an increase of 23% during the pandemic.…”

“…9 , 10 Outpatient volumes also have a larger impact on overall revenue for a hospital system with recent literature demonstrating a nearly 50% revenue loss for a large Midwest health system during the initial 8 weeks of the COVID-19 health crisis. 11 …”

Recover Wisely From COVID-19: Responsible Resumption of Nonurgent Radiology Services

“…There was a sharp, 53%–55% decrease in system wide volumes of imaging services in radiology departments in this 7–8-week time span ( 2 , 3 ).We have previously described our rescheduling implementation process for all nonurgent studies during the COVID-19 pandemic, using a tiered priority system to work through the scheduled outpatient radiology examinations that potentially could be delayed with minimal clinical impact ( 2 ).…”