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The mission of the Harvey L. Neiman Health Policy Institute® is to establish foundational evidence for health policy and radiology practice that promotes the effective and efficient use of health care resources and improves patient care.

August 10, 2021

Weekly Outpatient Imaging Volume Decreased Nearly 90% at its Peak During COVID-19 (April 2020) but Recovered to Pre-Pandemic Levels within 4 Months

Reston, VA – A new Harvey L. Neiman Health Policy Institute study found during a six-week period in March and April 2020, weekly outpatient imaging volume was 57% less than the same period in 2019. At its peak, the weekly imaging volume was down nearly 90% when examined on a weekly basis but recovered to pre-pandemic levels within 4 months. The concern is that delayed outpatient imaging can lead to diagnosis delays. This study published in Clinical Imaging was based on a retrospective review of all outpatient imaging performed in a large integrated healthcare system in New York state during the early weeks of the COVID-19 pandemic, when COVID cases in the United States were disproportionately concentrated in New York. The study included all imaging modalities (i.e., X-ray, mammography, CT, MRI, ultrasound, interventional radiology, and nuclear medicine).

The study showed that outpatient imaging volumes in 2020 prior to the health system’s first COVID-19 case were not statistically different than the same period in 2019. However, as the pandemic took hold and cases climbed, outpatient imaging volumes declined substantially during the March-April period (57%) compared to 2019 levels. “Our data reveals a complete return to pre-pandemic baseline volume per week, but the recovery took 3-4 months” said Jason J. Naidich, MD, MBA, FACR lead study author and Chair of Radiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.

“Recovery of outpatient imaging may be accelerated by public outreach and national campaigns demonstrating that imaging centers are safe and urging patients not to delay healthcare any longer” said Elizabeth Rula, Executive Director of the Neiman Institute. In New York state, there were 4 phases of reopening. However, “the recovery of outpatient imaging volume did not appear to be closely related to the local legislative policies for reopening of non-essential businesses.”

The study also examined the correlation between new positive-tested COVID-19 cases and outpatient imaging utilization and found a significant inverse correlation. These finding can be interpreted as “for every 1 new positive-tested COVID-19 case, there were 1.2 fewer outpatient imaging exams 1 week later” stated senior author Pina C. Sanelli, MD, MPH, FACR Vice Chair of Radiology Research, and the Director of the Imaging Clinical Effectiveness and Outcomes Research (iCEOR) division. “Although this analysis does not imply causation, it does shed light on another possible contributing factor affecting outpatient imaging utilization during the pandemic.”

To obtain a copy of the study or to arrange an interview with a spokesperson, contact Nichole Gay at (703) 648-1665 or



About the Harvey L. Neiman Health Policy Institute

The Harvey L. Neiman Health Policy Institute® is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care.Visit us at and follow us on Twitter, LinkedIn and Facebook.




Nichole Gay
Harvey L. Neiman Health Policy Institute