Optimizing Inpatient Body MRI Utilization: A Granular Look at Trends, Quality, Yield, and Timing

We sought to analyze body MRI utilization trends, quality, yield, and timing among inpatients in a tertiary care academic medical center.

By use of billing data from fiscal years (FYs) 2006-2015, the volume of admissions was compared with the total number of inpatient body MRI examinations. MRI examinations per admissions and discharge were adjusted using the Centers for Medicare & Medicaid Services case mix index by FY. Linear regression was used to assess trends. In addition, each inpatient body MRI examination performed in FY 2015 was evaluated and graded on its quality and yield and was judged as to whether it could have been performed on an outpatient basis.

There was an increase in the number of inpatient body MRI examinations, from 637 examinations in FY 2006 to 871 examinations in FY 2015 (p = 0.005). By adjusting for case mix, the upward trend for body MRI use persisted (p = 0.012). Regarding quality, 2.3% of all inpatient body MRI examinations were nondiagnostic, 40.4% were limited quality, and 57.3% were of diagnostic quality. Concerning yield, 20.8% of all examinations had no yield, 5.1% of examinations had no yield but incidental findings, and 74.1% of examinations had a positive yield. Finally, regarding timing, 30.2% of examinations could have been performed as outpatient examinations.

At our institution, the number of inpatient body MRI examinations has increased significantly over the past 10 years. Many of the examinations, however, are poor quality, often give redundant information, and could be performed in the outpatient setting.