David C. Levin (
Laurence Parker is an associate professor in the Department of Radiology at Thomas Jefferson University Hospital.
Health Aff (Millwood). 2017 Apr 1;36(4):663-670. doi: 10.1377/hlthaff.2016.0836.
Imaging is an important cost driver in health care, and its use grew rapidly in the early 2000s. Several studies toward the end of the decade suggested that a leveling off was beginning to occur. In this study we examined more recent data to determine whether the slowdown had continued. Our data sources were the nationwide Medicare Part B databases for the period 2001-14. We calculated utilization rates per 1,000 enrollees for all advanced imaging modalities. We also calculated professional component relative value unit (RVU) rates per 1,000 beneficiaries for all imaging modalities, as RVU values provide a measure of complexity of imaging services and may in some ways be a better reflection of the amount of work involved in imaging. We found that utilization rates and RVU rates grew substantially until 2008 and 2009, respectively, and then began to drop. The downward trend in both rates persisted through 2014. Federal policies appear to have achieved the desired effect of ending the rapid growth of imaging that had been seen in earlier years.
影像学检查是医疗保健的一个重要成本驱动因素,其使用在 21 世纪初迅速增长。在这十年接近尾声时,有几项研究表明,这种增长开始趋于平稳。在这项研究中,我们研究了最近的数据,以确定这种放缓是否仍在持续。我们的数据来源是 2001 年至 2014 年期间的全国性医疗保险 B 部分数据库。我们计算了每千名参保人所有高级影像学检查的使用率。我们还计算了每千名受益人所有影像学检查的专业组件相对价值单位(RVU)费率,因为 RVU 值可衡量影像学服务的复杂程度,并且在某种程度上可能更能反映影像学检查所涉及的工作量。我们发现,使用率和 RVU 率分别在 2008 年和 2009 年大幅增长,然后开始下降。这两个比率的下降趋势一直持续到 2014 年。联邦政策似乎已经达到了结束前几年影像学检查快速增长的预期效果。