Gyftopoulos Soterios, Harkey Paul, Hemingway Jennifer, Hughes Danny R, Rosenkrantz Andrew B, Duszak Richard
1 Department of Radiology, NYU Langone Medical Center, 660 First Ave, New York, NY 10016.
2 Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
AJR Am J Roentgenol. 2017 Nov;209(5):1103-1109. doi: 10.2214/AJR.17.18346. Epub 2017 Aug 4.
The objective of our study was to assess temporal changes in the utilization of musculoskeletal extremity imaging in Medicare beneficiaries over a recent 20-year period (1994-2013).
Medicare Physician Supplier Procedure Summary Master Files from 1994 through 2013 were used to study changing utilization and utilization rates of the four most common musculoskeletal imaging modalities: radiography, MRI, CT, and ultrasound.
Utilization rates (per 1000 beneficiaries) for all four musculoskeletal extremity imaging modalities increased over time: 43% (from 441.7 to 633.6) for radiography, 615% (5.4-38.6) for MRI, 758% (1.2-10.3) for CT, and 500% (1.8-10.8) for ultrasound. Radiologists were the most common billing specialty group for all modalities throughout the 20-year period, maintaining dominant market shares for MRI and CT (84% and 96% in 2013). In recent years, the second most common billing group was orthopedic surgery for radiography, MRI, and CT and podiatry for ultrasound. The physician office was the most common site of service for radiography, MRI, and ultrasound, whereas the hospital outpatient and inpatient settings were the most common sites for CT.
In the Medicare population, the most common musculoskeletal extremity imaging modalities increased substantially in utilization over the 2-decade period from 1994 through 2013. Throughout that time, radiology remained the most common billing specialty, and the physician office and hospital outpatient settings remained the most common sites of service. These insights may have implications for radiology practice leaders in making decisions regarding capital infrastructure, workforce, and training investments to ensure the provision of optimal imaging services for extremity musculoskeletal care.
我们研究的目的是评估在最近20年期间（1994 - 2013年）医疗保险受益人群中肌肉骨骼四肢成像检查的使用情况随时间的变化。
使用1994年至2013年的医疗保险医师供应商程序汇总主文件，研究四种最常见的肌肉骨骼成像方式（X线摄影、磁共振成像（MRI）、计算机断层扫描（CT）和超声）的使用情况及使用率的变化。
所有四种肌肉骨骼四肢成像方式的使用率（每1000名受益人）均随时间增加：X线摄影增加了43%（从441.7增至633.6），MRI增加了615%（从5.4增至38.6），CT增加了758%（从1.2增至10.3），超声增加了500%（从1.8增至10.8）。在这20年期间，放射科医生是所有成像方式最常见的计费专业组，在MRI和CT方面保持主导市场份额（2013年分别为84%和96%）。近年来，第二常见的计费组在X线摄影、MRI和CT方面是骨外科，在超声方面是足病科。医师办公室是X线摄影、MRI和超声最常见的服务地点，而医院门诊和住院环境是CT最常见的服务地点。
在医疗保险人群中，从1994年到2013年的20年期间，最常见的肌肉骨骼四肢成像方式的使用量大幅增加。在此期间，放射科仍然是最常见的计费专业，医师办公室和医院门诊环境仍然是最常见的服务地点。这些见解可能对放射科实践领导者在做出关于资本基础设施、劳动力和培训投资的决策方面具有启示意义，以确保为四肢肌肉骨骼护理提供最佳成像服务。
