Abstract
PURPOSE: The aim of this study was to assess inpatient radiology imaging utilization and workload trends at a large academic medical center from fiscal year (FY) 2013 to FY 2023. METHODS: This retrospective study included 896,005 imaging examinations from adult inpatients treated from October 1, 2012, to September 30, 2023 (FY 2013 to FY 2023) at an 866-bed tertiary care academic institution. Examinations were coded by modality-radiography (XR), CT, MRI, ultrasound, and nuclear medicine (NM)-and adjusted for disease severity using case-mix index. Relative value units (RVUs) were used to measure radiology workload. Linear regression analysis and the χ(2) test were used to assess trends in imaging examinations per case mix-adjusted admission (CMAA) and RVUs. RESULTS: Although total number of annual imaging examinations increased from 102,025 to 118,991 during the study period (P < .001), total imaging examinations per CMAA decreased (P < .001) because of decreases in XR, ultrasound, and NM examinations (P < .001 for all). However, radiology workload (professional, technical, and global) increased significantly (P < .001), attributable mainly to increased CT and MRI utilization (P < .001). Although CT and MRI examinations per CMAA increased by 19.2% and 21.4% respectively, professional RVUs increased by 80.6% for CT (P < .001) and by 90.7% for MRI (P < .001). Average length of stay increased by 32.1% from 5.6 to 7.4 days (P < .001) during the study period. CONCLUSIONS: Despite an overall decrease in disease severity-adjusted inpatient imaging utilization, inpatient radiology workload increased significantly over the decade as advanced imaging replaced lower cost modalities. Greater reliance on CT and MRI, possibly influenced by coronavirus disease of 2019 practice changes and not fully explained by disease severity, was associated with longer inpatient stays.