As medical resources shifted away from elective and non-urgent procedures toward emergent and critical care of COVID-19 patients, departments were forced to reconfigure their personnel and resources. In particular, many radiology practices rescheduled non-urgent and routine imaging according to recommendations from the American College of Radiology (ACR).
This new Harvey L. Neiman Health Policy Institute study, published online in the Journal of American College of Radiology (JACR), evaluates the change in the inpatient imaging volumes and composition mix during the COVID-19 pandemic within a large healthcare system.
The researchers did a retrospective review of the inpatient imaging case volumes in a large integrated healthcare system from January 1, 2019 – April 18, 2020 to evaluate the change in the imaging volumes and composition mix according to imaging modality types and billing code (CPT) data during the COVID-19 pandemic. The weekly aggregated imaging volumes were provided in 2020 and 2019 for the inpatient service classified by the imaging modality types. Individual billing code (CPT) data within each modality type was also provided as weekly aggregated data to further evaluate the case volumes for specific types of imaging exams.
“Overall, the 2020 inpatient imaging volume during the post-COVID-19 (weeks 10-16) period declined by 13.6% compared to 2019. However, when further analyzing the post-COVID-19 period, a greater decline of 16.6% was observed in the 2020 early post-COVID-19 (weeks 10-13) period. However, the total inpatient imaging volume started to increase in the late post-COVID-19 (weeks 14-16) period. By week 16, the inpatient imaging volume only declined by 4.2%,” says Pina Sanelli, MD, vice chair of radiology research, and the director of the Imaging Clinical Effectiveness and Outcomes Research division.
“Importantly, a significant shift in the composition mix of imaging modality types was also observed in the 2020 late post-COVID-19 (weeks 14-16) period with increased use of radiography relative to advanced imaging (CT, MRI, ultrasound, interventional procedures, nuclear medicine).”
This study also revealed increased imaging volumes for specific CPT-coded groups in the late post-COVID-19 (weeks 14-16) period for CTA chest, radiography chest and ultrasound venous duplex. The results from this study may have significant implications for leaders preparing for a potential resurgence of the COVID-19 crisis. This real-world data should be useful in preparing for potential resource utilization and staffing requirements. In particular, these results may be helpful in developing new imaging utilization guidelines and departmental policies aimed at optimally accommodating the unique imaging needs for COVID-19 patients.
Radiology practices can plan in advance for adequate staffing, as well as develop safe and efficient decontamination procedures in specific imaging modalities (radiography, ultrasound and CT). Additionally, radiologists with clinical expertise for the specific CPT-coded imaging exams (radiography chest, CTA chest and ultrasound venous duplex) will be valuable in providing high-quality care.
“The results from this study provide data from our experience to inform radiology practices regarding not only the decline in inpatient imaging volumes, but more importantly the significant shift in the imaging composition mix during the COVID-19 pandemic,” says Jason Naidich, MD, lead study author and chair of radiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. “This study may assist in guiding inpatient practice decisions based on the shift in the imaging volumes across different modality types and specific CPT-coded groups in order to provide optimal access and availability of the imaging resources necessary during the COVID-19 pandemic.”