Brown Scott C, Wang Kefeng, Dong Chuanhui, Farrell Mary Beth, Heller Gary V, Gornik Heather L, Hutchisson Marge, Needleman Laurence, Benenati James F, Jaff Michael R, Meier George H, Perese Susana, Bendick Phillip, Hamburg Naomi M, Lohr Joann M, LaPerna Lucy, Leers Steven A, Lilly Michael P, Tegeler Charles, Katanick Sandra L, Alexandrov Andrei V, Siddiqui Adnan H, Rundek Tatjana
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida USA
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida USA, Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida USA.
J Ultrasound Med. 2016 Sep;35(9):1957-65. doi: 10.7863/ultra.15.08021. Epub 2016 Jul 27.
Accreditation of cerebrovascular ultrasound laboratories by the Intersocietal Accreditation Commission (IAC) and equivalent organizations is supported by the Joint Commission certification of stroke centers. Limited information exists on the accreditation status and geographic distribution of cerebrovascular testing facilities in the United States. Our study objectives were to identify the proportion of IAC-accredited outpatient cerebrovascular testing facilities used by Medicare beneficiaries, describe their geographic distribution, and identify variations in cerebrovascular testing procedure types and volumes by accreditation status.
As part of the VALUE (Vascular Accreditation, Location, and Utilization Evaluation) Study, we examined the proportion of IAC-accredited facilities that conducted cerebrovascular testing in a 5% Centers for Medicare and Medicaid Services random Outpatient Limited Data Set in 2011 and investigated their geographic distribution using geocoding.
Among 7327 outpatient facilities billing Medicare for cerebrovascular testing, only 22% (1640) were IAC accredited. The proportion of IAC-accredited cerebrovascular testing facilities varied by region (χ(2)[3] = 177.1; P < .0001), with 29%, 15%, 13%, and 10% located in the Northeast, South, Midwest, and West, respectively. However, of the total number of cerebrovascular outpatient procedures conducted in 2011 (38,555), 40% (15,410) were conducted in IAC-accredited facilities. Most cerebrovascular testing procedures were carotid duplex, with 40% of them conducted in IAC-accredited facilities.
The proportion of facilities conducting outpatient cerebrovascular testing accredited by the IAC is low and varies by region. The growing number of certified stroke centers should be accompanied by more accredited outpatient vascular testing facilities, which could potentially improve the quality of stroke care.
卒中中心的联合委员会认证支持了由社会间认证委员会（IAC）及同等组织对脑血管超声实验室进行的认证。关于美国脑血管检测设施的认证状况和地理分布的信息有限。我们的研究目的是确定医疗保险受益人使用的经IAC认证的门诊脑血管检测设施的比例，描述其地理分布，并确定按认证状况划分的脑血管检测程序类型和数量的差异。
作为VALUE（血管认证、位置和利用评估）研究的一部分，我们在2011年医疗保险和医疗补助服务中心5%的随机门诊有限数据集里，检查了进行脑血管检测的经IAC认证的设施比例，并使用地理编码调查了它们的地理分布。
在7327家向医疗保险机构开具脑血管检测账单的门诊设施中，只有22%（1640家）获得了IAC认证。经IAC认证的脑血管检测设施的比例因地区而异（χ(2)[3]=177.1；P<.0001），分别有29%、15%、13%和10%位于东北部、南部、中西部和西部。然而，在2011年进行的脑血管门诊程序总数（38555例）中，40%（15410例）是在经IAC认证的设施中进行的。大多数脑血管检测程序是颈动脉双功超声检查，其中40%是在经IAC认证的设施中进行的。
经IAC认证进行门诊脑血管检测的设施比例较低，且因地区而异。认证卒中中心数量的增加应伴随着更多经认证的门诊血管检测设施，这可能会提高卒中护理的质量。
