Department of Radiology, NYU Langone Health, New York, NY, USA.
Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA.
Skeletal Radiol. 2024 Nov;53(11):2347-2355. doi: 10.1007/s00256-024-04643-1. Epub 2024 Mar 9.
To report osteoporosis screening utilization rates among Asian American (AsA) populations in the USA.
We retrospectively assessed the use of dual-energy X-ray absorptiometry (DXA) screening using the Medicare 5% Research Identifiable Files. Using Current Procedural Terminology (CPT) codes indicative of a DXA scan, we identified patients recommended for DXA screening according to the ACR-SPR-SSR Practice Parameters (females ≥ 65 years, males ≥ 70 years). Sociodemographic factors and their association with screening were evaluated using chi-square tests.
There were 80,439 eligible AsA beneficiaries, and 12,102 (15.1%) received osteoporosis screening. DXA rate for women was approximately four times greater than the rate for men (19.8% vs. 5.0%; p < 0.001). AsA beneficiaries in zip codes with higher mean household income (MHI) were more likely to have DXA than those in lower MHI areas (17.6% vs. 14.3%, p < 0.001). AsA beneficiaries aged < 80 were more likely to receive DXA (15.5%) than those aged ≥ 80 (14.1%, p < 0.001). There were 2,979,801 eligible non-AsA beneficiaries, and 496,957 (16.7%) received osteoporosis screening during the study period. Non-Hispanic white beneficiaries had the highest overall screening rate (17.5%), followed by North American Native (13.0%), Black (11.8%), and Hispanic (11.1%) beneficiaries. Comparing AsA to non-AsA populations, there were significantly lower DXA rates among AsA beneficiaries when controlling for years of Medicare eligibility, patient age, sex, location, and mean income (p < 0.001).
We found lower than expected DXA screening rates for AsA patients. A better understanding of the barriers and facilitators to AsA osteoporosis screening is needed to improve patient care.
报告美国亚裔美国人（AsA）人群中骨质疏松症筛查的利用情况。
我们使用医疗保险 5%研究可识别文件，回顾性评估了双能 X 射线吸收法（DXA）筛查的使用情况。使用表示 DXA 扫描的当前程序术语（CPT）代码，根据美国放射学会-骨骼放射学会-脊柱放射学会实践参数（女性≥65 岁，男性≥70 岁），我们确定了推荐进行 DXA 筛查的患者。使用卡方检验评估社会人口统计学因素及其与筛查的关联。
有 80439 名符合条件的 AsA 受益人群，其中 12102 人（15.1%）接受了骨质疏松症筛查。女性 DXA 率约为男性的四倍（19.8%对 5.0%；p<0.001）。邮政编码中平均家庭收入（MHI）较高的 AsA 受益人群比 MHI 较低地区的人群更有可能接受 DXA（17.6%对 14.3%，p<0.001）。年龄<80 岁的 AsA 受益人群比年龄≥80 岁的人群更有可能接受 DXA（15.5%对 14.1%，p<0.001）。有 2979801 名符合条件的非 AsA 受益人群，在此期间有 496957 人（16.7%）接受了骨质疏松症筛查。非西班牙裔白人受益人群的总体筛查率最高（17.5%），其次是北美原住民（13.0%）、黑人（11.8%）和西班牙裔（11.1%）受益人群。与非 AsA 人群相比，在控制了 Medicare 参保年限、患者年龄、性别、地点和平均收入后，AsA 受益人群的 DXA 筛查率显著较低（p<0.001）。
我们发现 AsA 患者的 DXA 筛查率低于预期。需要更好地了解 AsA 骨质疏松症筛查的障碍和促进因素，以改善患者护理。
