Li Jennifer M, Ho David R, Husain Nazia, Biederman Robert W, Finn J Paul, Fuisz Anthon R, Saeed Ibrahim M, Nguyen Kim-Lien
University of Arizona College of Medicine, Phoenix, Arizona, USA; David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
J Cardiovasc Magn Reson. 2024;26(2):101061. doi: 10.1016/j.jocmr.2024.101061. Epub 2024 Jul 11.
Clinical guidelines and scientific data increasingly support the appropriate use of cardiovascular magnetic resonance (CMR) . The extent of CMR adoption across the United States (US) remains unclear. This observational analysis aims to capture CMR practice patterns in the US.
Commissioned reports from the Society for Cardiovascular Magnetic Resonance (SCMR), pre-existing survey data from CMR centers, and socioeconomic and coronary heart disease data from the Centers for Disease Control and Prevention were used. The location of imaging centers performing CMR was based on 2018 Medicare claims. Secondary analysis was performed on center-specific survey data from 2017-2019, which were collected by members of the SCMR US Advocacy Subcommittee for quality improvement purposes. The correlation between the number of imaging centers billing for CMR services per million persons, socioeconomic determinants, and coronary heart disease epidemiology was determined.
A total of 591 imaging centers billed the Center for Medicare & Medicaid Services for CMR services in 2018 and 112 (of 155) unique CMR centers responded to the survey. In 2018, CMR services were available in almost all 50 states. Minnesota was the state with the highest number of CMR centers per million Medicare beneficiaries (52.6 centers per million), and Maine had the lowest (4.4 per million). The total density of CMR centers was 16 per million for US Medicare beneficiaries. Sixty-eight percent (83 of 112) of survey responders were cardiologists, and 28% (31/112) were radiologists. In 72% (71/112) of centers, academic health care systems performed 81%-100% of CMR exams. The number of high-volume centers (>500 scans per year) increased by seven between 2017 and 2019. In 2019, 53% (59/112) of centers were considered high-volume centers and had an average of 19 years of experience. Centers performing <50 scans had on average 3.5 years of experience. Approximate patient wait time for a CMR exam was 2 weeks to 1 month.
Despite increasing volume and availability in almost all 50 states, CMR access remains geographically variable. Advocacy efforts to improve access and innovations that reduce imaging time and exam complexity have the potential to increase the adoption of CMR technology.
临床指南和科学数据越来越支持心血管磁共振成像（CMR）的合理应用。美国全国范围内CMR的采用程度仍不明确。这项观察性分析旨在了解美国CMR的应用模式。
使用了心血管磁共振学会（SCMR）委托撰写的报告、CMR中心预先存在的调查数据以及疾病控制与预防中心的社会经济和冠心病数据。进行CMR成像的中心位置基于2018年医疗保险理赔情况。对SCMR美国宣传小组委员会成员为质量改进目的收集的2017 - 2019年特定中心调查数据进行了二次分析。确定了每百万人口中开具CMR服务账单的成像中心数量、社会经济决定因素和冠心病流行病学之间的相关性。
2018年共有591个成像中心向医疗保险和医疗补助服务中心开具了CMR服务账单，155个独立CMR中心中有112个回复了调查。2018年，几乎美国所有50个州都提供CMR服务。明尼苏达州是每百万医疗保险受益人中CMR中心数量最多的州（每百万有52.6个中心），缅因州最少（每百万4.4个）。美国医疗保险受益人的CMR中心总密度为每百万16个。68%（112个中有83个）的调查回复者是心脏病专家，28%（112个中有31个）是放射科医生。在72%（112个中有71个）的中心，学术医疗系统进行了81% - 100%的CMR检查。2017年至2019年，高流量中心（每年>500次扫描）的数量增加了7个。2019年，53%（112个中有59个）的中心被视为高流量中心，平均有19年经验。进行少于50次扫描的中心平均有3.5年经验。CMR检查的患者大致等待时间为2周至1个月。
尽管几乎在所有50个州CMR的使用量和可及性都在增加，但CMR的可及性在地理上仍存在差异。为改善可及性所做的宣传努力以及减少成像时间和检查复杂性的创新措施有可能增加CMR技术的采用率。
