神经放射学解读的专业费用由谁收取，是放射科医生还是非放射科医生？

Who collects professional fees for neuroradiology interpretation, radiologists or nonradiologists?

机构信息

The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.

出版信息

J Am Coll Radiol. 2012 Jul;9(7):498-505. doi: 10.1016/j.jacr.2012.02.010.

DOI:10.1016/j.jacr.2012.02.010

PMID:22748792

Abstract

PURPOSE

An increasing portion of imaging studies are performed by nonradiologists, especially for modalities with the highest relative value units. The aim of this study was to examine the trends in neuroradiologic interpretation among radiologists, neurologists, neurosurgeons, and other specialists within the Medicare population.

METHODS

The number of neuroradiologic studies interpreted by radiologists, neurologists, neurosurgeons, and other specialists in the inpatient, hospital outpatient, and private office settings was determined from the CMS Physician/Supplier Procedure Summary Master Files for 1996 to 2010. Studies billed through professional and global charges were aggregated. Utilization rates and utilization rate compound annual growth rates were computed by specialty and by imaging study.

RESULTS

In 1996, radiologists interpreted 4,802,490 (93.7%) CMS neuroradiologic procedures, neurologists 77,312 (1.5%), neurosurgeons 9,825 (0.19%), and other specialists 234,423 (4.6%). In 2010, radiologists interpreted 11,476,376 (93.5%) procedures, neurologists 101,172 (0.8%), neurosurgeons 20,697 (0.17%), and other specialists 680,786 (5.5%). Neurology and neurosurgery lost market share at all sites. Radiology's share increased in the inpatient (from 94.8% to 98.7%) and hospital outpatient (from 95% to 98.7%) settings but decreased in the private office setting (from 88.2% to 73.1%). Lost market share was captured by the other CMS specialty categories, including independent diagnostic testing facilities and multidisciplinary groups, many of which included radiologists.

CONCLUSIONS

There was marked growth (140%) in neuroradiologic studies between 1996 and 2010 in the Medicare patient population. Radiologists' share of the total neuroradiologic interpretations remained unchanged and constituted 93.5% in 2010. Radiology's market share has shown growth in the inpatient and hospital outpatient sectors but not the private office sector, where independent diagnostic testing facilities, multidisciplinary groups, and other specialists have seen increases.

摘要

目的

越来越多的影像学研究由非放射科医生进行，尤其是对于相对价值单位较高的检查。本研究旨在调查医疗保险人群中神经放射学解释的趋势，包括放射科医生、神经科医生、神经外科医生和其他专科医生。

方法

从 1996 年至 2010 年 CMS 医师/供应商程序摘要主文件中确定放射科医生、神经科医生、神经外科医生和其他专科医生在住院、医院门诊和私人诊所环境中进行的神经放射学研究数量。通过专业和全球收费计费的研究被汇总。按专业和影像学检查计算使用率和使用率复合年增长率。

结果

1996 年，放射科医生解释了 4802490 例 CMS 神经影像学程序，神经科医生 77312 例（1.5%），神经外科医生 9825 例（0.19%），其他专科医生 234423 例（4.6%）。2010 年，放射科医生解释了 11476376 例程序，神经科医生 101172 例（0.8%），神经外科医生 20697 例（0.17%），其他专科医生 680786 例（5.5%）。在所有地点，神经科和神经外科的市场份额都有所下降。放射科在住院（从 94.8%增加到 98.7%）和医院门诊（从 95%增加到 98.7%）环境中的份额增加，但在私人诊所环境中的份额下降（从 88.2%下降到 73.1%）。其他 CMS 专科类别（包括独立诊断检测设施和多学科小组）占据了失去的市场份额，其中许多都包括放射科医生。

结论

在 Medicare 患者群体中，1996 年至 2010 年间神经影像学研究显著增长（140%）。放射科医生在总神经放射学解释中的份额保持不变，2010 年为 93.5%。放射科的市场份额在住院和医院门诊部门有所增长，但在私人诊所部门没有增长，独立诊断检测设施、多学科小组和其他专科医生的市场份额有所增加。