Department of Diagnostic Radiology, NewYork-Presbyterian Hospital/Cornell Medical Center, 1320 York Ave, #27K, New York, NY 10021, USA.
Radiology. 2012 Jul;264(1):146-53. doi: 10.1148/radiol.12110993. Epub 2012 Apr 24.
To ascertain the effects of the payment reductions in the Deficit Reduction Act (DRA), which affected only in-office imaging, on the utilization of noninvasive musculoskeletal imaging.
This study of nonidentifiable aggregate data did not require institutional review board approval. Medicare Part B Physician/Supplier Procedure Summary Files for 2004, 2006, and 2008 were used. By using descriptive statistics and weighted linear regression, all 111 relevant procedure codes were evaluated to measure the effect of the DRA's payment reductions on change in utilization growth rate between the pre-DRA (2004-2006) and post-DRA (2006-2008) periods.
Overall, between the pre-DRA and post-DRA periods, the type of imaging studied demonstrated a 2% deceleration (reduction in per capita utilization growth rate) in the office and a 0.7% deceleration in the outpatient hospital setting. However, nonradiologist and radiologist utilization were both still growing, particularly for nonradiographic imaging. In the office, for both nonradiologists and radiologists, larger DRA payment reductions were associated with greater deceleration; deceleration was approximately 0.2% greater for each additional 1% of reimbursement reduction. There was no payment-reduction-size-related acceleration in the outpatient setting.
The growth rate of in-office noninvasive musculoskeletal imaging performed by nonradiologists and the growth rate of this type of imaging being referred to radiologists decreased in the period following the implementation of the DRA. Nonetheless, after the DRA, in-office nonradiographic noninvasive musculoskeletal imaging performed by nonradiologists was still growing much more rapidly than that performed by radiologists.
确定仅影响门诊影像的《赤字削减法案》（DRA）减支对非侵入性肌肉骨骼影像使用的影响。
这项对不可识别的汇总数据的研究不需要机构审查委员会的批准。使用了 Medicare Part B Physician/Supplier Procedure Summary Files 2004、2006 和 2008 年的数据。通过使用描述性统计和加权线性回归，评估了所有 111 个相关程序代码，以衡量 DRA 付款减少对预 DRA（2004-2006 年）和后 DRA（2006-2008 年）期间利用增长率变化的影响。
总体而言，在预 DRA 和后 DRA 期间，所研究的成像类型在门诊环境中显示出 2%的减速（人均利用增长率降低），而在门诊医院环境中则减速 0.7%。然而，非放射科医生和放射科医生的利用仍在增长，特别是对于非放射成像。在门诊环境中，对于非放射科医生和放射科医生，DRA 付款减少幅度越大，减速幅度越大；每增加 1%的报销减少，减速幅度大约增加 0.2%。在门诊环境中，没有与付款减少幅度相关的加速。
在 DRA 实施后，非放射科医生进行的门诊非侵入性肌肉骨骼成像的增长率和这种类型的成像被转介给放射科医生的增长率下降。尽管如此，在 DRA 之后，非放射科医生进行的门诊非放射性非侵入性肌肉骨骼成像的增长率仍比放射科医生进行的增长率快得多。
