Brown Scott C, Wang Kefeng, Dong Chuanhui, Yi Li, Marinovic Gutierrez Carolina, Di Tullio Marco R, Farrell Mary Beth, Burgess Pamela, Gornik Heather L, Hamburg Naomi M, Needleman Laurence, Orsinelli David, Robison Susana, Rundek Tatjana
Departments of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
Departments of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA.
J Ultrasound Med. 2018 Feb;37(2):397-402. doi: 10.1002/jum.14349. Epub 2017 Aug 8.
Accreditation of echocardiographic testing facilities by the Intersocietal Accreditation Commission (IAC) is supported by the American College of Cardiology and American Society of Echocardiography. However, limited information exists on the accreditation status and geographic distribution of echocardiographic facilities in the United States. Our study aimed to identify (1) the proportion of outpatient echocardiography facilities used by Medicare beneficiaries that are IAC accredited, (2) their geographic distribution, and (3) variations in procedure type and volume by accreditation status.
As part of the VALUE-ECHO (Value of Accreditation, Location, and Utilization Evaluation-Echocardiography) study, we examined the proportion of IAC-accredited echocardiographic facilities performing outpatient echocardiography in the 2013 Centers for Medicare and Medicaid Services outpatient limited data set (100% sample) and their geographic distribution using geocoding in ArcGIS (ESRI, Redlands, CA).
Among 4573 outpatient facilities billing Medicare for echocardiographic testing in 2013, 99.6% (n = 4554) were IAC accredited (99.7% in the 50 US states and 86.2% in Puerto Rico). The proportion IAC-accredited echocardiographic facilities varied by region, with 98.7%, 99.9%, 99.9%, 99.5%, and 86.2% of facilities accredited in the Northeast, South, Midwest, West, and Puerto Rico, respectively (P < .01, Fisher exact test). Of all echocardiographic outpatient procedures conducted (n = 1,890,156), 99.8% (n = 1,885,382) were performed in IAC-accredited echocardiographic facilities. Most procedures (90.9%) were transthoracic echocardiograms, of which 99.7% were conducted in IAC-accredited echocardiographic facilities.
Almost all outpatient echocardiographic facilities billed by Medicare are IAC accredited. This accreditation rate is substantially higher than previously reported for US outpatient vascular testing facilities (13% IAC accredited). The uniformity of imaging and interpretation protocols from a single accrediting body is important to facilitate optimal cardiovascular care.
超声心动图检查设施由社会间认证委员会（IAC）进行认证，这得到了美国心脏病学会和美国超声心动图学会的支持。然而，关于美国超声心动图设施的认证状态和地理分布的信息有限。我们的研究旨在确定：（1）医疗保险受益人群体所使用的门诊超声心动图设施中获得IAC认证的比例；（2）它们的地理分布；以及（3）根据认证状态划分的检查类型和检查量的差异。
作为VALUE - ECHO（认证价值、地点及利用评估 - 超声心动图）研究的一部分，我们在2013年医疗保险和医疗补助服务中心门诊有限数据集（100%样本）中，检查了进行门诊超声心动图检查的IAC认证超声心动图设施的比例，并使用ArcGIS（ESRI，加利福尼亚州雷德兰兹）中的地理编码确定其地理分布。
在2013年向医疗保险机构收取超声心动图检查费用的4573家门诊设施中，99.6%（n = 4554）获得了IAC认证（在美国50个州为99.7%，在波多黎各为86.2%）。IAC认证的超声心动图设施比例因地区而异，在东北部、南部、中西部、西部和波多黎各，获得认证的设施比例分别为98.7%、99.9%、99.9%、99.5%和86.2%（P <.01，Fisher精确检验）。在所有进行的超声心动图门诊检查中（n = 1,890,156），99.8%（n = 1,885,382）是在IAC认证的超声心动图设施中进行的。大多数检查（90.9%）是经胸超声心动图，其中99.7%是在IAC认证的超声心动图设施中进行的。
几乎所有向医疗保险机构收费的门诊超声心动图设施都获得了IAC认证。这一认证率远高于此前报道的美国门诊血管检查设施的认证率（13%获得IAC认证）。来自单一认证机构的成像和解读方案的一致性对于促进最佳心血管护理很重要。
