Outpatient imaging slowly recovered during pandemic

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Outpatient imaging volume slowly recovered in New York during the first wave of the COVID-19 pandemic to prepandemic levels, but the decline in imaging was greater than its recovery, according to research published August 9 in Clinical Imaging.

Researchers led by Dr. Jason Naidich from Northwell Health in New York found an estimated loss of 120,335 outpatient imaging exams over the course of 25 weeks after the pandemic's peak, raising concern for potential future negative effects on population health.

"In order to appropriately plan for the post-pandemic imaging needs of the population, understanding the rate, duration and pattern of imaging recovery would be instrumental in directing healthcare resources," wrote Naidich and colleagues.

Radiology practices saw significant reductions in outpatient imaging volumes during the pandemic. New York quickly became an epicenter of COVID-19 after the first case in the state was confirmed in early March, and New York at one point had the highest number of confirmed cases of any state after the pandemic's arrival in the U.S.

The team wanted to evaluate the timing, rate, and degree of recovery of outpatient imaging during the first wave of the pandemic at Northwell's healthcare system in the New York City metropolitan area. Researchers also wanted to find out the relationship of outpatient imaging recovery to the incidence of COVID-19 cases.

They looked at volumes at different time periods in January through August 2020 and compared them to the same periods in 2019. These included pre-COVID (weeks 1-9), peak-COVID (weeks 10-15), and recovery-COVID (weeks 16-34).

Several imaging methods were included in the study, including x-ray, mammography, CT, MRI, ultrasound, interventional radiology, and nuclear medicine.

The team found that the total outpatient imaging case volume performed at the health system in 2020 from January through August was 327,738 exams, compared to 440,314 exams in 2019 during the same period.

Average weekly imaging volumes in 2020 significantly decreased in the peak-COVID and recovery-COVID periods. The average weekly decline was -2,580 exams per week, while the recovery rate was +617 exams per week.

"The recovery was slow and prolonged relative to the steep peak-pandemic decline. This resulted in an estimated total decrease of 120,335 outpatient imaging exams during the first wave of the pandemic," study authors wrote.

A significant inverse correlation of -0.8338 (p < 0.0001) was also seen between positive-tested COVID cases and imaging use with a one-week lag during the post-COVID period.

Researchers said the return in outpatient imaging occurred prior to the implementation of the national vaccination program in the U.S. and without a known cure for COVID-19 infection.

They also said recovery of outpatient imaging may speed up through public outreach and national campaigns showing that imaging centers are safe and urging patients not to delay healthcare.

"These findings may help inform radiology practices regarding other contributing factors influencing outpatient imaging utilization during the recovery period," they said.

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