Rosenkrantz Andrew B, Bilal Nadia H, Hughes Danny R, Duszak Richard
Department of Radiology, NYU Langone Medical Center, New York, NY.
Harvey L. Neiman Health Policy Institute, Reston, VA.
Am J Emerg Med. 2014 Dec;32(12):1470-5. doi: 10.1016/j.ajem.2014.09.002. Epub 2014 Sep 6.
To assess recent national specialty trends in the use of diagnostic ultrasound (US) services in the Emergency Department (ED) setting.
We searched aggregated 1998-2012 Medicare Part B Master Files for ED diagnostic US studies, excluding cardiac and ophthalmic examinations. Studies were classified by body part and interpreting specialty. Subsequent analysis was performed for higher-volume services rendered by emergency physicians for which discrete codes were present longitudinally for complete vs limited examinations. National trends were analyzed.
From 1998 to 2012, paid ED US studies interpreted by radiologists, emergency physicians, and all other physicians increased by 332% (from 221,712 to 735,858 examinations), 4454% (from 561 to 24,992), and 251% (from 26,961 to 67,787), respectively. The fraction of ED US examinations interpreted remained around 90% for radiologists, increased from 0.2% to 3% for emergency physicians, and decreased from 11% to 8% for other physicians. The fraction of complete abdominal and complete retroperitoneal studies interpreted by emergency physicians remained less than 1% from 1998 through 2012. However, emergency physicians experienced disproportionate growth in limited examinations (from 1% to 9% for abdominal studies and from <1% to 20% for retroperitoneal studies). Likewise, the fraction of (typically targeted) chest studies interpreted by emergency physicians increased from less than 1% to 63%.
From 1998 to 2012, there was substantial growth in ED US studies for Medicare beneficiaries interpreted by radiologists and emergency physicians alike. For more commonly performed services distinguishable as complete vs limited in nature, growth in services by emergency physicians was most dramatic for less complex services.
评估近期全国范围内急诊科（ED）使用诊断性超声（US）服务的专业趋势。
我们在1998 - 2012年医疗保险B部分主文件中汇总搜索了急诊科诊断性超声检查研究，不包括心脏和眼科检查。研究按身体部位和解读专业进行分类。随后对急诊医生提供的大量服务进行分析，这些服务在完整检查与有限检查方面有纵向的离散编码。分析全国趋势。
1998年至2012年，由放射科医生、急诊医生和所有其他医生解读的付费急诊科超声检查分别增加了332%（从221,712次检查增至735,858次）、4454%（从561次增至24,992次）和251%（从26,961次增至67,787次）。放射科医生解读的急诊科超声检查比例仍保持在90%左右，急诊医生的比例从0.2%增至3%，其他医生的比例从11%降至8%。1998年至2012年，急诊医生解读的完整腹部和完整腹膜后检查比例仍低于1%。然而，急诊医生在有限检查方面增长不成比例（腹部检查从1%增至9%，腹膜后检查从<1%增至20%）。同样，急诊医生解读的（通常为针对性的）胸部检查比例从不到1%增至63%。
1998年至2012年，放射科医生和急诊医生为医疗保险受益人解读的急诊科超声检查都有显著增长。对于性质上可区分为完整与有限的更常见检查服务，急诊医生在较简单服务方面的增长最为显著。
