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

Lang, Min; Yeung, Tsz-Lun; Mendoza, Dexter P.; Flores, Efrén J.; Som, Avik; Lang, Angela L.; Pianykh, Oleg S.; Lee, Susanna I.; Saini, Sanjay; Little, Brent P.; Succi, Marc D.

doi:10.1016/j.acra.2020.08.008

Cited by 34 publications

(41 citation statements)

References 18 publications

(31 reference statements)

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“…As a result, complexity remained elevated throughout the system months after the outbreak peak. Similarly asymmetric changes between academic sites and nonacademic imaging centers were also previously reported from a large system in Massachusetts ( 22 ).…”

Section: Discussionsupporting

confidence: 76%

Sources of Revenue Loss and Recovery in Radiology Practices During the Coronavirus Disease 2019 (COVID-19) Pandemic

et al. 2021

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Rationale and Objectives: 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. Materials and Methods: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 1À9), surge (10À19), and recovery (20À33), 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.Results: 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 (À14.7%), cardiothoracic imaging (À16.2%), and community hospitals overall (À15.9%). 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. Conclusion: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.

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Section: Discussionsupporting

confidence: 76%

Sources of Revenue Loss and Recovery in Radiology Practices During the Coronavirus Disease 2019 (COVID-19) Pandemic

et al. 2021

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“…Nuclear medicine has been one of the imaging modalities that exhibited the greatest degree of volume reduction during the COVID-19 pandemic [12,13,17,18]. In our study, we observed a reduction of around 43% in nuclear medicine examinations volume between the periods directly before and during the lockdown.…”

Section: Discussionsupporting

confidence: 53%

Quantitative impact of the first COVID-19 lockdown on nuclear medicine in France: the CORALINE study

Vigne

Peyronnet

Leenhardt

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose The coronavirus disease 2019 (COVID-19) pandemic reshaped the usual risk: benefit equilibrium that became a tradeoff between the infection exposure risk for the patient (and for staff) and the risk associated with delaying or cancelling the nuclear medicine examination. This study aimed at quantifying the impact of the first COVID-19 lockdown in France on nuclear medicine examination volume together with volume of examination cancellation and non-attendance. Methods We retrospectively assessed the volume of planned examinations from 1 month before to 1 month after the first lockdown in French high-volume nuclear medicine departments (NMD) sharing the same information management system including both university hospitals, UH (n = 7), and cancer centres, CC (n = 2). Results The study enrolled 31,628 consecutive patients referred for a nuclear medicine examination performed or not (NMEP or NMEnP). The total volume of NMEP significantly dropped by 43.4% between the 4 weeks before and after the starting of the lockdown. The comparison of the percentage of NMEP and NMEnP between UH and CC is significantly different (p < 0.001). The percentage of NMEP during the study was 67.9% in UH vs 84.7% in CC. Percentages of NMEnP in UH and CC were due respectively to cancellation by the patient (14.9 vs 7.4%), cancellation by the NMD (9.5 vs 3.4%), cancellation by the referring physician (5.1 vs 4.4%) and non-attender patients (2.7 vs 0.2%). ConclusionThe study underlines the public health issue caused by COVID-19 above the pandemic itself and should be useful in preparing for potential resource utilisation and staffing requirements.This article is part of the Topical Collection on Miscellanea

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“… 1 Our prior research demonstrated hospital-wide overall volume decreases of 54–64%. 5 The authors speculate that the magnitude of decline in imaging volume is multifactorial - population density, patient catchment area, severity of COVID-19 outbreaks, and social distancing policies are a few of many possible factors.…”

Section: Discussionmentioning

confidence: 99%

“… 4 While recent studies on imaging volume in the context of the pandemic have highlighted absolute declines in imaging utilization and corresponding work relative value unit (wRVU) data, specific data on changes in per-patient utilization, including data by modality and corresponding wRVU, have not been reported. 5. , 6.…”

Section: Introductionmentioning

confidence: 99%

Increased per-patient imaging utilization in an emergency department setting during COVID-19

Succi

Chang

et al. 2021

Clinical Imaging

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Introduction 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. Methods 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. Results 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. Conclusion We report increased per-patient imaging utilization in an emergency department during COVID-19, particularly in patients without respiratory complaints.

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

Cited by 34 publications

References 18 publications

Sources of Revenue Loss and Recovery in Radiology Practices During the Coronavirus Disease 2019 (COVID-19) Pandemic

Sources of Revenue Loss and Recovery in Radiology Practices During the Coronavirus Disease 2019 (COVID-19) Pandemic

Quantitative impact of the first COVID-19 lockdown on nuclear medicine in France: the CORALINE study

Increased per-patient imaging utilization in an emergency department setting during COVID-19

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