Section chief, Abdominal Imaging, Director of Health Policy, and Director of Prostate Imaging, Department of Radiology, NYU Langone Health, New York, New York.
Harvey L. Neiman Health Policy Institute, Reston, Virginia.
J Am Coll Radiol. 2020 Sep;17(9):1116-1122. doi: 10.1016/j.jacr.2020.06.001. Epub 2020 Jul 5.
To characterize national trends in oncologic imaging (OI) utilization.
This retrospective cross-sectional study used 2004 and 2016 CMS 5% Carrier Claims Research Identifiable Files. Radiologist-performed, primary noninvasive diagnostic imaging examinations were identified from billed Current Procedural Terminology codes; CT, MRI, and PET/CT examinations were categorized as "advanced" imaging. OI examinations were identified from imaging claims' primary International Classification of Diseases-9 and International Classification of Diseases-10 codes. Imaging services were stratified by academic practice status and place of service. State-level correlations of oncologic advanced imaging utilization (examinations per 1,000 beneficiaries) with cancer prevalence and radiologist supply were assessed by Spearman correlation coefficient.
The national Medicare sample included 5,051,095 diagnostic imaging examinations (1,220,224 of them advanced) in 2004 and 5,023,115 diagnostic imaging examinations (1,504,608 of them advanced) in 2016. In 2004 and 2016, OI represented 4.3% and 3.9%, respectively, of all imaging versus 10.8% and 9.5%, respectively, of advanced imaging. The percentage of advanced OI done in academic practices rose from 18.8% in 2004 to 34.1% in 2016, leaving 65.9% outside academia. In 2016, 58.0% of advanced OI was performed in the hospital outpatient setting and 23.9% in the physician office setting. In 2016, state-level oncologic advanced imaging utilization correlated with state-level radiologist supply (r = +0.489, P < .001) but not with state-level cancer prevalence (r = -0.139, P = .329).
OI usage varied between practice settings. Although the percentage of advanced OI done in academic settings nearly doubled from 2004 to 2016, the majority remained in nonacademic practices. State-level oncologic advanced imaging utilization correlated with radiologist supply but not cancer prevalence.
描述全国范围内肿瘤影像学（OI）应用的趋势。
本回顾性横断面研究使用了 2004 年和 2016 年 CMS 5%的承保人索赔研究可识别文件。由计费的当前程序术语代码确定放射科医生执行的主要非侵入性诊断成像检查；CT、MRI 和 PET/CT 检查被归类为“高级”成像。OI 检查由成像索赔的主要国际疾病分类第 9 版和国际疾病分类第 10 版代码确定。根据学术实践状况和服务地点对成像服务进行分层。通过 Spearman 相关系数评估肿瘤高级成像利用（每 1000 名受益人检查次数）与癌症流行率和放射科医生供应的国家相关性。
国家医疗保险样本包括 2004 年的 5051095 次诊断性影像学检查（其中 1220224 次为高级影像学检查）和 2016 年的 5023115 次诊断性影像学检查（其中 1504608 次为高级影像学检查）。2004 年和 2016 年，OI 分别占所有影像学的 4.3%和 3.9%，而高级影像学分别占 10.8%和 9.5%。2004 年至 2016 年，学术实践中进行的高级 OI 百分比从 18.8%上升到 34.1%，而 65.9%的 OI 则在学术界之外进行。2016 年，58.0%的高级 OI 在医院门诊进行，23.9%在医生办公室进行。2016 年，州级肿瘤高级成像利用率与州级放射科医生供应相关（r=+0.489，P<.001），但与州级癌症流行率无关（r=-0.139，P=.329）。
OI 的使用在不同的实践环境中有所不同。尽管 2004 年至 2016 年，学术环境中进行的高级 OI 百分比几乎翻了一番，但大部分仍在非学术环境中进行。州级肿瘤高级成像利用率与放射科医生供应相关，但与癌症流行率无关。
