Levin David C, Parker Laurence, Sunshine Jonathan H, Pentecost Michael J
Department of Radiology, Thomas Jefferson University Hospital, 111 S. 11th St., Philadelphia, PA 19107, USA.
AJR Am J Roentgenol. 2002 Feb;178(2):303-6. doi: 10.2214/ajr.178.2.1780303.
Our research was conducted to ascertain the importance of noninvasive cardiovascular imaging to the practice of radiology and to determine what percentages of noninvasive cardiovascular imaging are performed by radiologists and by other types of physicians.
Using the national 1998 Medicare Part B database, we reviewed all 460 procedure codes pertaining to noninvasive diagnostic imaging and identified 65 that were specifically related to the cardiovascular system. These 65 codes were grouped in five categories: cardiac MR imaging, MR angiography, cardiovascular nuclear medicine, echocardiography, and vascular sonography. For each code and category, we determined the nationwide examination volume, the utilization rate per 1,000 Medicare fee-for-service enrollees, Part B physician reimbursements, and the percentages of examinations performed by radiologists, cardiologists, surgeons, and other physicians.
During 1998, 19,244,001 noninvasive cardiovascular imaging studies were performed on Medicare enrollees, which accounted for 17.7% of all Medicare diagnostic imaging studies carried out that year and 33.6% of all Part B imaging-related reimbursements paid. The utilization rate for noninvasive cardiovascular imaging was 603 per 1,000 Medicare enrollees per year. Echocardiography alone accounted for 63.4% of these examinations. Radiologists conducted 16.7% of all noninvasive cardiovascular imaging, whereas cardiologists conducted 61.5%, surgeons 4.8%, and other physicians 16.9% of the examinations. The strong role of cardiologists was largely attributable to their dominance in echocardiography. Radiologists had a substantial role in all categories except echocardiography.
Noninvasive cardiovascular imaging represents an important component of the practice of radiology. Radiologists have substantial participation in all aspects of the field with the exception of echocardiography.
开展本研究以确定非侵入性心血管成像在放射学实践中的重要性，并确定放射科医生及其他类型医生进行的非侵入性心血管成像的比例。
利用1998年全国医疗保险B部分数据库，我们查阅了所有460个与非侵入性诊断成像相关的程序代码，并确定了65个与心血管系统具体相关的代码。这65个代码分为五类：心脏磁共振成像、磁共振血管造影、心血管核医学、超声心动图和血管超声检查。对于每个代码和类别，我们确定了全国检查量、每1000名医疗保险按服务收费参保人的使用率、B部分医生报销费用，以及放射科医生、心脏病专家、外科医生和其他医生进行检查的比例。
1998年期间，医疗保险参保人共进行了19,244,001项非侵入性心血管成像研究，占该年所有医疗保险诊断成像研究的17.7%，以及所有B部分成像相关报销费用的33.6%。非侵入性心血管成像的使用率为每年每1000名医疗保险参保人603次。仅超声心动图就占这些检查的63.4%。放射科医生进行了所有非侵入性心血管成像的16.7%，而心脏病专家进行了61.5%，外科医生进行了4.8%，其他医生进行了16.9%的检查。心脏病专家的重要作用很大程度上归因于他们在超声心动图方面的主导地位。放射科医生在除超声心动图外的所有类别中都发挥了重要作用。
非侵入性心血管成像代表了放射学实践的一个重要组成部分。放射科医生除了超声心动图外，在该领域的各个方面都有大量参与。
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