Many IR procedures could not be delayed during the pandemic due to their ‘central role in patient care’

Outpatient interventional radiology volumes took less of a hit during the onset of pandemic compared to diagnostic radiology and other surgical specialties, according to a new single-center study. The findings indicate that many IR procedures could not be delayed, underscoring the specialty’s importance to patient care.

University Hospitals Cleveland Medical Center researchers compared IR and diagnostic imaging volumes between March 17 and April 20, during the state-mandated shutdown of non-essential services.

Overall interventional numbers did drop dramatically, with a 41% and 25% decline in outpatient and inpatient volumes, respectively. But systemwide diagnostic imaging totals fell harder, with outpatient exams nosediving by 57% and inpatient volumes declining 22%.

Other specialties, such as vascular surgery, urology and general surgery, also reported higher procedural drops compared to IR.

It’s yet another reminder of the field’s growing presence in healthcare, which represented about 18.4% or $68.4 billion of adult inpatient spending in 2016 alone.

“The Ohio governor's department of health order defined any non-essential procedure as a procedure that can be delayed without undue risk to the current or future health of the patient,” Ahmad Hashmi, with the Cleveland center’s radiology department, and colleagues wrote Tuesday in Clinical Imaging. “This finding may underscore the notion that a substantial number of IR procedures were unable to be delayed due to their central role in patient care.”

Hashmi et al. noted IR procedures overall decreased by 35%, compared to the 45% decline in diagnostic radiology exams. The proportion of interventional oncology and dialysis procedures did not change (p>0.05), while drainage procedures did increase (p<0.05).

Most specialties included in this analysis saw volumes fall furthest in April, compared to baseline figures. General surgery, gastroenterology and gynecology were hit hardest, dropping by 63%, 79% and 73%, respectively. 

Looking at their data, Hashmi and colleagues believe there should be a discussion about redefining essential services to include IR and outpatient-based labs or ambulatory surgery centers. They noted such resources were underutilized during COVID’s onset but could play a key role in future emergencies.

They also explained that their analysis can help guide operational strategies for hospitals during future crises.

“Our observations can be used to explore the potential role of IR in emergency preparedness protocols, redefining ‘essential’ procedures for different IR practices, evaluating revenue benefits by further boosting essential outpatient procedural volume, acknowledging an ever-growing and definable difference between IR and DR practice, and triaging resource allocation at the department and system-level during a health crisis like COVID-19,” the authors concluded.

There is a lot more to glean from the full analysis, which can be read in Clinical Imaging here.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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