Imaging interpretation turnaround times for Medicare fee-for-service beneficiaries increased steeply between 2021 and 2023, particularly for CT and MRI exams, according to a study published March 30 in the Journal of the American College of Radiology.
The trend suggests that the "radiology workforce has reached maximum capacity," and may negatively affect patient outcomes, wrote a team led by Eric Christensen, PhD, of the Harvey L. Neiman Health Policy Institute (HPI) in Reston, VA.
"Delays in imaging reports have been associated with longer hospital length of stay and, for CT and MR specifically, higher episode costs," the group explained. "For time-critical conditions, faster imaging, interpretation, and subsequent treatment are associated with improved outcomes [and] for routine imaging, faster receipt of results is associated with reduced patient anxiety and greater satisfaction with care."
The current radiology workforce shortage is the result of a combination of increased imaging demand per patient, an aging population, and a limited supply of radiologists, Christensen and colleagues wrote.
"As this shortage persists, there are growing concerns about impacts on both radiologists (e.g., burnout) and patient care (e.g., access)," they noted. "To some degree, radiologists have managed the shortage by working more and increasing time devoted to clinical work at the expense of non-clinical duties (i.e., teaching, research, leadership), but such strategies have limits."
The team conducted a study that consisted of data from a 5% sample of Medicare fee-for-service beneficiaries between 2014 and 2023. The group evaluated days between office and hospital outpatient imaging exams (CT, MR, ultrasound, x-ray, or fluoroscopy) acquisition and exam interpretation, and matched technical claims (that is, for imaging acquisition) with professional claims (for interpretation) by beneficiary and procedure code. Christensen and colleagues tracked overall annual turnaround times by modality, patient, radiologist characteristics, and day of the week.
The study included 2.6 million imaging exams. The team reported that overall, mean days to interpretation for the study period were 0.109, but this measure varied over the study time period, ranging from 0.091 in 2014 to 0.193 in 2023 -- an increase of 113%.
Interpretation times also varied by modality:
Rise in interpretation turnaround times by modality as turnover rates increased, 2014 to 2023 | |
Modality | Turnaround time |
| CT | +318% |
| MRI | +256% |
| Ultrasound | +140% |
| X-ray and fluoroscopy | +63% |
The authors found that these trends differed somewhat by community income, area deprivation index (ADI), and urbanicity, "with more disadvantaged communities generally having longer turnaround times."
The bottom line? The workload surge is affecting radiologists' ability to absorb volume increases, leading to longer exam interpretation times, Christensen told AuntMinnie.com.
"Once all slack time is eliminated, any delay will postpone the start of the next task," he said. "So increasing turnaround time for imaging interpretation can signal challenges … [and although our] study does not address what can be done, logical options are to increase capacity through increasing the size of the workforce or to reduce demand through reducing the amount of low-value imaging studies that are ordered.
"Of course, neither option is easy."
Access the full study here.
