Evaluating the Effect of Expanding Clinical Services and Departments at a Tertiary Medical Center on the Neuroradiology Section

Background: Expansion of clinical services at tertiary medical centers is expected to affect the volume and complexity of neuroradiology imaging, yet the cumulative effect of such expansion has not been systematically documented over time at a single center. This study aimed to quantify changes in examination volume, referral source, complexity, on-call workload, and reporting times in the neuroradiology section of Shaare Zedek Medical Center between 2020 and 2025, alongside clinical service expansion during this period.

Methods: A retrospective single-center study based on radiology information system (RIS) data. Quarterly data on neuroradiology computed tomography (CT) and magnetic resonance imaging (MRI) examinations were collected, including volume, referral source (emergency department [ED], inpatient, outpatient), age, protocol complexity, time of examination, and reporting times. Trends were assessed using negative binomial regression with an offset for ED visits, logistic regression for proportions, and log-transformed linear regression for reporting times.

Results: Between Q1 2020 and Q1 2025, CT and MRI volumes rose by 39.9% and 86.6%, respectively. After adjusting for ED visits, the imaging rate increased significantly by ~2.4%/year (incidence rate ratio [IRR] 1.006/quarter, 95% confidence interval [CI] 1.003-1.009). Complex examinations increased by ~14.3%/year (odds ratio [OR] 1.034/quarter, 95% CI 1.032-1.036), while simple examinations decreased by 4.7%/year. On-call imaging increased by ~7.4%/year. Reporting times for senior radiologists increased significantly (β=0.192/quarter, p<0.001), while resident reporting times remained stable (β=0.003, p=0.745); the resident-senior gap widened significantly with increasing complexity.

Conclusions: At a growing tertiary medical center, neuroradiology imaging volume and complexity increased continuously, alongside a significant rise in senior radiologists` workload and reporting times. Workforce planning in imaging departments should be based on measures beyond examination counts alone, accounting also for complexity and workload.