美国医疗保险受益人群 2000 至 2015 年光疗应用趋势。

Trends in phototherapy utilization among Medicare beneficiaries in the United States, 2000 to 2015.

机构信息

Harvard Medical School, Boston, Massachusetts.

Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.

出版信息

J Am Acad Dermatol. 2018 Oct;79(4):672-679. doi: 10.1016/j.jaad.2018.03.018. Epub 2018 Mar 21.

DOI:10.1016/j.jaad.2018.03.018

PMID:29574089

Abstract

BACKGROUND

Phototherapy is a cost-effective treatment for many dermatoses, yet the emergence of alternative therapies such as biologics led many to think that phototherapy utilization was declining.

OBJECTIVE

To characterize national, historical phototherapy utilization and costs among Medicare beneficiaries.

METHODS

Longitudinal analysis of the Medicare Part B National Summary Data File from 2000 to 2015 for phototherapy billing codes. Geographic distribution of clinics and provider type obtained from the Medicare Provider Utilization and Payment Data for 2012 to 2015.

RESULTS

The overall volume of phototherapy services billed to Medicare from 2000 to 2015 increased by 5% annually, from 334,670 to 692,093. Ultraviolet B therapy comprised 77% of phototherapy volume, utilization of psoralen plus ultraviolet A therapy declined by 9% annually, and excimer laser services grew by 29% annually. The number of phototherapy clinics is increasing but remains concentrated in only 11% of US counties. Between 2012 and 2015, dermatologists accounted for 92% of phototherapy volume.

LIMITATIONS

Commercial payers and institutional claims (hospital-based physicians) are excluded. Clinical indications for phototherapy use are not reported in this database.

CONCLUSION

Phototherapy utilization has grown, though the service mix has shifted toward ultraviolet B and laser excimer therapy and away from psoralen plus ultraviolet A therapy. Dermatologists manage most phototherapy. Uneven geographic distribution of phototherapy clinics limits access in nonurban areas, and further evaluation is needed to determine its impact on rural communities.

摘要

背景

光疗是治疗许多皮肤病的一种具有成本效益的方法，但替代疗法如生物制剂的出现，让许多人认为光疗的应用正在减少。

目的

描述医疗保险受益人群中全国范围内光疗的应用和费用情况。

方法

对 2000 年至 2015 年医疗保险 B 部分国家汇总数据文件中光疗计费代码进行纵向分析。2012 年至 2015 年从医疗保险提供者使用和支付数据中获取诊所和提供者类型的地理分布。

结果

2000 年至 2015 年，向医疗保险报销的光疗服务量每年增长 5%，从 334670 次增至 692093 次。紫外线 B 治疗占光疗量的 77%，补骨脂素加紫外线 A 治疗的使用率每年下降 9%，准分子激光服务每年增长 29%。光疗诊所的数量在增加，但仍集中在全美 11%的县。2012 年至 2015 年期间，皮肤科医生占光疗量的 92%。