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急诊部门各种影像学检查方式的使用趋势:2000 年至 2008 年全国医疗保险数据。

Trends in utilization rates of the various imaging modalities in emergency departments: nationwide Medicare data from 2000 to 2008.

机构信息

Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.

出版信息

J Am Coll Radiol. 2011 Oct;8(10):706-9. doi: 10.1016/j.jacr.2011.04.004.

DOI:10.1016/j.jacr.2011.04.004
PMID:21962785
Abstract

PURPOSE

To study utilization trends in the various imaging modalities in emergency departments (EDs) over a recent multiyear period.

METHODS

The nationwide Medicare Part B databases for 2000 to 2008 were queried. Medicare's location codes were used to identify imaging examinations done on ED patients. All diagnostic imaging Current Procedural Terminology(®) codes were grouped by modality. For each code, the database provides procedure volume; utilization rates per 1,000 beneficiaries were then calculated. Medicare's physician specialty codes were used to determine provider specialty. Utilization trends were studied between 2000 and 2008.

RESULTS

The overall utilization rate per 1,000 beneficiaries for all imaging in EDs increased from 281.0 in 2000 to 450.4 in 2008 (+60%). The radiography utilization rate rose from 227.3 in 2000 to 294.3 in 2008 (+29%, 67 accrued new studies per 1,000). The CT rate rose from 40.0 in 2000 to 130.7 in 2008 (+227%, 90.7 accrued new studies per 1,000). The ultrasound rate rose from 9.6 in 2000 to 18.7 in 2008 (+95%, 9.1 accrued new studies per 1,000). Other modalities had much lower utilization. In 2000, CT constituted 14% of all ED imaging, but by 2008, it constituted 29%. In 2008, radiologists performed 96% of all ED imaging examinations.

CONCLUSIONS

The rate of utilization of imaging is increasing in EDs. Growth is by far the most pronounced in CT, in terms of both the growth rate itself and the actual number of accrued new studies per 1,000 beneficiaries. Radiologists strongly predominate as the physicians of record for all ED imaging.

摘要

目的

研究近年来急诊部(ED)各种影像学模式的利用趋势。

方法

对 2000 年至 2008 年的全国医疗保险 B 部分数据库进行了查询。使用医疗保险的位置代码来识别在 ED 患者中进行的影像学检查。将所有诊断影像学当前程序术语(®)代码按模态分组。对于每个代码,数据库提供程序量;然后计算每 1000 名受益人的利用率。使用医疗保险的医生专业代码来确定提供者的专业。研究了 2000 年至 2008 年之间的利用趋势。

结果

ED 中所有影像学检查的每 1000 名受益人的总体利用率从 2000 年的 281.0 增加到 2008 年的 450.4(增加 60%)。放射学利用率从 2000 年的 227.3 增加到 2008 年的 294.3(增加 29%,每 1000 名新增 67 项研究)。CT 率从 2000 年的 40.0 增加到 2008 年的 130.7(增加 227%,每 1000 名新增 90.7 项研究)。超声率从 2000 年的 9.6 增加到 2008 年的 18.7(增加 95%,每 1000 名新增 9.1 项研究)。其他模式的利用率要低得多。2000 年,CT 占所有 ED 影像学的 14%,但到 2008 年,这一比例上升到 29%。2008 年,放射科医生进行了所有 ED 影像学检查的 96%。

结论

ED 中影像学的利用率正在增加。就增长率本身和每 1000 名受益人的实际新增研究数量而言,增长最为显著的是 CT。放射科医生作为所有 ED 影像学的记录医生占据主导地位。

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