While COVID-19 has resulted in decreases in absolute imaging volumes, imaging utilisation on a per-patient basis has not been reported. A surprising new study published in Clinical Imaging shows that clinicians are more likely to request imaging for non-respiratory patients during the COVID-19 pandemic.

Researchers compared per-patient imaging utilisation, characterised by imaging studies and work relative value units (wRVUs), in an emergency department (ED) during a 30-day COVID-19 surge to the same period in 2019.

Massachusetts researchers studied found that during 30-days of a COVID-19 surge, patients from a large, urban academic medical centre, who presented to the emergency department without respiratory complaints generated 24% more wRVUs/patient and 33% more studies/patient, compared to 2019.

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This single-institution retrospective study included patients presenting to the ED from April 1–May 1, 2020, a period considered to be the height of the COVID-19 pandemic in Massachusetts and compared them to patients presenting during the same period in 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.

There was a 170% relative increase in patients presenting to the ED with respiratory complaints, but this subgroup averaged only 53% wRVU/patient vs. non-respiratory patients.

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.

Investigators note that this study is the first to report increased per-patient imaging utilisation during COVID-19, characterised by significantly increased studies and wRVUs. 

They also identified a significantly increased proportion of patients receiving imaging as well as increased admitted patients, suggesting that less-acute patients are avoiding care. 

Authors of the study conclude that as the effects of COVID-19 on radiology practices continue to evolve, knowledge of individualised utilisation growth metrics may help departments understand and plan for imaging trends.

Source: Clinical Imaging

Photo: iStock

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Succi MD, Chang K, An T et al. (2021) Increased per-patient imaging utilisation in an emergency department setting during COVID-19. Clinical Imaging, ISSN 0899-7071, Published: June 07, 2021 DOI:https://doi.org/10.1016/j.clinimag.2021.06.003

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Imaging, Radiology, emergency medicine, emergency department imaging, cost-effective healthcare, pandemic, COVID-19 While COVID-19 has resulted in decreases in absolute imaging volumes, imaging utilisation on a per-patient basis has not been reported. A surprising new s...