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

Abstract

Rationale and objectives: While affiliated imaging centers play an important role in healthcare systems, little is known of how their operations are impacted by the COVID-19 pandemic. Our goal was to investigate imaging volume trends during the pandemic at our large academic hospital compared to the affiliated imaging centers.

Materials and methods: This was a descriptive retrospective study of imaging volume from an academic hospital (main hospital campus) and its affiliated imaging centers from January 1 through May 21, 2020. Imaging volume assessment was separated into prestate of emergency (SOE) period (before SOE in Massachusetts on March 10, 2020), "post-SOE" period (time after "nonessential" services closure on March 24, 2020), and "transition" period (between pre-SOE and post-SOE).

Results: Imaging volume began to decrease on March 11, 2020, after hospital policy to delay nonessential studies. The average weekly imaging volume during the post-SOE period declined by 54% at the main hospital campus and 64% at the affiliated imaging centers. The rate of imaging volume recovery was slower for affiliated imaging centers (slope = 6.95 for weekdays) compared to main hospital campus (slope = 7.18 for weekdays). CT, radiography, and ultrasound exhibited the lowest volume loss, with weekly volume decrease of 41%, 49%, and 53%, respectively, at the main hospital campus, and 43%, 61%, and 60%, respectively, at affiliated imaging centers. Mammography had the greatest volume loss of 92% at both the main hospital campus and affiliated imaging centers.

Conclusion: Affiliated imaging center volume decreased to a greater degree than the main hospital campus and showed a slower rate of recovery. Furthermore, the trend in imaging volume and recovery were temporally related to public health announcements and COVID-19 cases.

Keywords: COVID-19; Imaging volume; Pandemic; Radiology operation; Service locations.

Fig. 1

(a) Daily new COVID-19 cases in state of Massachusetts and across our healthcare system from January 1, 2020 through May 21, 2020. (b) Timeline of imaging volume during the COVID-19 pandemic. Daily imaging volume by modality type at the main hospital campus and affiliated imaging centers and new COVID-19 cases in Massachusetts from January 1, 2020 to May 21, 2020. The blue flags mark notable local, state, and national COVID-19 events. The periodic pattern in imaging volume and COVID-19 census comes from the weekly pattern, with lower numbers corresponding to weekends. (Color version of figure is available online.)

Fig. 2

Daily volume at the main hospital. (a) Daily imaging volume by modality type at the main hospital campus from January 2020 to May 2020. Gray zone marks the significant decline in daily imaging volume during the transition period, the time between the pre-SOE and post-SOE periods. (b) Trend of the total study volume at the main hospital campus during the pre-SOE, transition, and post-SOE during weekdays. (c) Trend of the total study volume at the main hospital campus during the pre-SOE, transition, and post-SOE during weekends.

Fig. 3

Daily volume at the affiliated outpatient imaging centers. (a) Daily imaging volume by modality type at the affiliated imaging centers from January 2020 to May 2020. Gray zone marks the significant decline in daily imaging volume during the transition period, the time between the pre-SOE and post-SOE periods. (b) Trend of the total study volume at the affiliated imaging centers during the pre-SOE, transition, and post-SOE during weekdays. (c) Trend of the total study volume at the affiliated imaging centers during the pre-SOE, transition, and post-SOE during weekends.

Fig. 4

Percent change of weekly imaging volume by modality type at (a) main hospital campus and (b) affiliated imaging centers, from January 2020 through May 2020. Gray zone marks the significant decline in weekly imaging volume during the transition period, the time between the pre-SOE and post-SOE periods. Average weekly imaging volume of weeks 1–9 (pre-SOE period) was used as reference and considered 100%. The percentage listed beside each imaging modality represent the percent of baseline volume recovery at week 19.