Inpatient Imaging Utilization and Radiology Workload: Trends of the Past Decade and Through the COVID-19 Pandemic

Area of Science:

• Radiology
• Medical Imaging
• Healthcare Analytics

Background:

• Inpatient radiology imaging utilization and workload are critical metrics for academic medical centers.
• Understanding trends is essential for resource allocation and patient care quality.

Purpose of the Study:

• To assess inpatient radiology imaging utilization and workload trends over a decade (FY2013-2023) at a major academic medical center.
• To analyze the impact of imaging modality shifts on workload and patient outcomes.

Main Methods:

• Retrospective analysis of 896,005 inpatient imaging examinations (radiograph, CT, MRI, US, NM) from FY2013-2023.
• Examinations adjusted for disease severity using case-mix index; workload measured by Relative Value Units (RVUs).
• Linear regression and chi-squared tests assessed trends in imaging examinations per case-mix-adjusted admission (CMAA) and RVUs.

Main Results:

• Total imaging examinations increased, but examinations per CMAA decreased due to reduced use of radiograph, ultrasound, and nuclear medicine.
• Radiology workload (professional, technical, global RVUs) significantly increased (p<.001), driven by higher CT and MRI utilization.
• CT and MRI examinations per CMAA rose 19.2% and 21.4%, with professional RVUs increasing 80.6% and 90.7%, respectively. Average length of stay increased 32.1%.

Conclusions:

• Inpatient radiology workload significantly rose over the decade, driven by advanced imaging (CT, MRI) replacing lower-cost modalities, despite decreased disease severity-adjusted utilization.
• Increased reliance on CT and MRI, potentially influenced by COVID-19, was associated with longer inpatient stays.
• These findings highlight a shift in imaging practice impacting hospital resource utilization and patient length of stay.