title: Analysis of radiologists' imaging workload trends by place of service.
abstract: OBJECTIVE
  The aim of this study was to determine what proportion of noninvasive diagnostic imaging (NDI) work done by radiologists occurred in each of the 4 primary places of service where imaging is conducted.
  
  
  METHODS
  Medicare's Physician/Supplier Procedure Summary Master Files for 2000 to 2011 were the data source. Specialty codes were used to identify radiologists, and place-of-service codes identified studies done in hospital outpatient facilities, hospital inpatient facilities, private offices, and emergency departments (EDs). The applicable total professional component relative value units (RVUs) were assigned to each NDI Current Procedural Terminology code, and RVU rates per 1,000 Medicare beneficiaries were calculated. RVU rates reflect workload and costs and are therefore a better metric than utilization rates based on volume.
  
  
  RESULTS
  From 2000 to 2006, radiologists' RVU rates per 1,000 Medicare beneficiaries increased in each of the 4 primary venues. However, from 2006 to 2011, rates remained essentially flat in hospital outpatient and inpatient facilities and offices but continued to increase in EDs. Absolute RVU rate increases from 2000 through 2011 were 289 in hospital outpatient facilities, 218 in EDs, 194 in private offices, and 99 in inpatient facilities. In 2011, 19% of radiologists' workload occurred in offices; the remainder was conducted in the 3 hospital settings. Twice as much elective outpatient NDI work by radiologists was done in hospital outpatient facilities as in radiologists' private offices.
  
  
  CONCLUSIONS
  Radiologists' workload in hospital outpatient and inpatient facilities and offices grew from 2000 through 2006, but no further growth occurred thereafter. EDs were the only venue where growth continued. The vast proportion of radiology NDI RVUs (81% in 2011) are produced in hospital settings.
authors: Center for Research on Utilization of Imaging Services (CRUISE), Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania; HealthHelp, Inc, Houston, Texas. Electronic address: david.levin@jeffersonhospital.org.
authors: David C
authors: DC
authors: Levin
authors: Vijay M
authors: VM
authors: Rao
authors: Laurence
authors: L
authors: Parker
authors: Andrea J
authors: AJ
authors: Frangos
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data* / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006278:Medicare / Q000706:statistics & numerical data / Q000639:trends*; D011331:Private Practice / Q000706:statistics & numerical data / Q000639:trends*; D011871:Radiology / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States; D014600:Utilization Review; D016526:Workload / Q000706:statistics & numerical data*
keywords: Outpatient imaging; imaging trends; imaging utilization; private office radiology; radiology and radiologists; socioeconomic issues