Outpatient imaging suffers massive declines at mega hospital system located in COVID epicenter

The largest hospital system located in America’s center of the COVID-19 crisis is pulling back the curtain on massive losses in imaging volume it has suffered since March. Investigators hope such data could prove pivotal in making a case for further relief from federal and state governments.

All told, New York City-based Northwell Health sustained a roughly 28% drop in radiology services delivered during the seven-week period ending April 18 when compared to the previous year. Outpatient imaging has taken the hardest hit, dropping by 88%, with its emergency departments (46%) and inpatient settings (4%) also seeing downturns, experts reported Saturday in JACR.

“Our study demonstrates the magnitude of the disruption caused by the pandemic and suggests that practices that depend on outpatient imaging will be most severely affected,” study lead author Jason Naidich, MD, a radiologist, senior VP and executive director of Northwell Health’s Central Region, said in a statement. “Even though healthcare institutions and small businesses may be eligible for some economic relief from a variety of government programs, the crisis has placed significant financial strain on many practices and radiologists. More assistance may be necessary as the pace and degree of recovery remain uncertain.”

Northwell Health—with 23 hospitals and 17 imaging centers—said it has also seen year-over-year decreases in imaging volume across all modalities. Mammography has been hit the hardest, with a 94% drop, followed by nuclear medicine (85%), MRI (74%), ultrasound (64%), and interventional radiology (56%). CT scans and x-ray imaging, both touted as tools to assess COVID patients, suffered the smallest declines at 46% and 22%, respectively. This occurred at a time when the hospital group did not experience any changes in the availability of scanners to perform such exams, according to the analysis.

Naidich and co-authors from several institutions believe this is the first published study, stratified by service line and modality, to describe the magnitude of the pandemic’s impact on imaging. While the results may not be generalizable given Northwell’s massive scale and urban location, they believe this information could provide an assist to any practice in planning for the future and seeking relief from regulators.

“Since the duration of the COVID-19 pandemic remains uncertain, this study may assist in guiding short-term and long-term practice decisions based on the magnitude of imaging volume decline across different patient service locations and specific imaging modality types during the COVID-19 pandemic,” concluded Naidich and colleagues. “Importantly, this data may play a vital role in demonstrating the impact on radiology practices to support requests for funding relief from the government COVID-19 recovery plans”