Original Article
Early-Stage Radiology Volume Effects and Considerations with the Coronavirus Disease 2019 (COVID-19) Pandemic: Adaptations, Risks, and Lessons Learned

https://doi.org/10.1016/j.jacr.2020.07.001Get rights and content

Abstract

Objective

The coronavirus disease 2019 (COVID-19) pandemic resulted in significant loss of radiologic volume as a result of shelter-at-home mandates and delay of non-time-sensitive imaging studies to preserve capacity for the pandemic. We analyze the volume-related impact of the COVID-19 pandemic on six academic medical systems (AMSs), three in high COVID-19 surge (high-surge) and three in low COVID-19 surge (low-surge) regions, and a large national private practice coalition. We sought to assess adaptations, risks of actions, and lessons learned.

Methods

Percent change of 2020 volume per week was compared with the corresponding 2019 volume calculated for each of the 14 imaging modalities and overall total, outpatient, emergency, and inpatient studies in high-surge AMSs and low-surge AMSs and the practice coalition.

Results

Steep examination volume drops occurred during week 11, with slow recovery starting week 17. The lowest total AMS volume drop was 40% compared with the same period the previous year, and the largest was 70%. The greatest decreases were seen with screening mammography and dual-energy x-ray absorptiometry scans, and the smallest decreases were seen with PET/CT, x-ray, and interventional radiology. Inpatient volume was least impacted compared with outpatient or emergency imaging.

Conclusion

Large percentage drops in volume were seen from weeks 11 through 17, were seen with screening studies, and were larger for the high-surge AMSs than for the low-surge AMSs. The lowest drops in volume were seen with modalities in which delays in imaging had greater perceived adverse consequences.

Key Words

Adaptations
COVID-19
pandemic
recovery
volume

Cited by (0)

Dr Norbash reports personal fees from GE, Siemens, Penumbra, Stryker, IBM, and stock with Boston Imaging Core Laboratories, outside the submitted work. Dr Brink reports personal fees from Accumen, Inc, outside the submitted work. Dr Hess reports personal fees from General Electric, Siemens Healthineers, Focused Ultrasound Foundation, and the RSNA, outside the submitted work. The other authors state that they have no conflict of interest related to the material discussed in this article. Dr Norbash, Dr Moore, Dr Recht, Dr Brink, Dr Hess, Mr Won, Dr Jain, Dr Sun, Dr Brown, and Dr Enzmann are nonpartner, non–partnership track employees.

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