Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, 132 S 10th St., Main 1090, Philadelphia, PA 19107, USA.
AJR Am J Roentgenol. 2011 Jan;196(1):W25-9. doi: 10.2214/AJR.10.4835.
The purpose of this article is to determine whether there has been any change in the rapid growth pattern that has characterized noninvasive diagnostic imaging in recent years.
The annual nationwide Medicare Part B databases were used. All Current Procedural Terminology codes for discretionary noninvasive diagnostic imaging were identified. The overall utilization rates per 1,000 fee-for-service beneficiaries were calculated from 1998 through 2008, as were rates by modality. Determination was made as to whether studies were interpreted by radiologists or nonradiologist physicians.
The total utilization rate of noninvasive diagnostic imaging grew at a compound annual growth rate of 4.1% from 1998 to 2005, but this decreased to 1.4% from 2005 to 2008. From 2005 through 2008, the overall growth trends flattened dramatically for MRI and nuclear medicine and abated somewhat for CT, ultrasound, and echocardiography. In ambulatory settings, flattening of the advanced imaging growth curves was seen in both private offices and hospital outpatient facilities. From 1998 to 2005, the compound annual growth rate was 3.4% among radiologists and 6.6% among nonradiologist physicians. From 2005 to 2008, the compound annual growth rate decreased to 0.8% among radiologists and 1.8% among nonradiologists.
There has been a distinct slowing in the growth of discretionary noninvasive diagnostic imaging in the Medicare fee-for-service population since 2005. The slowdown has been most pronounced in MRI and nuclear medicine. This should allay some of the concerns of policymakers and payers. Both before and after 2005, growth was approximately twice as rapid among nonradiologist physicians as among radiologists.
本文旨在确定近年来无创性诊断成像的快速增长模式是否发生了变化。
使用了全国性的医疗保险 B 部分年度数据库。确定了所有可选的无创性诊断成像的现行手术术语代码。从 1998 年到 2008 年，按每 1000 名付费受益人的总体利用率进行了计算，并按模式进行了分类。确定这些研究是由放射科医生还是非放射科医生进行解读的。
从 1998 年到 2005 年，无创性诊断成像的总利用率以 4.1%的复合年增长率增长，但从 2005 年到 2008 年，这一增长率降至 1.4%。从 2005 年到 2008 年，MRI 和核医学的总体增长趋势急剧放缓，CT、超声和超声心动图的增长也有所放缓。在门诊环境中，私人诊所和医院门诊设施中的高级成像增长曲线也趋于平稳。从 1998 年到 2005 年，放射科医生的复合年增长率为 3.4%，非放射科医生的增长率为 6.6%。从 2005 年到 2008 年，放射科医生的复合年增长率降至 0.8%，而非放射科医生的增长率为 1.8%。
自 2005 年以来，医疗保险自费人群中可选的无创性诊断成像的增长率明显放缓。MRI 和核医学的放缓最为明显。这应该可以减轻政策制定者和支付者的一些担忧。无论是在 2005 年之前还是之后，非放射科医生的增长率都大约是放射科医生的两倍。
