Dual-energy X-ray Absorptiometry Trends Among US Medicare Beneficiaries: 2005–2019

IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Tyler Prout , Casey Pelzl , Eric W. Christensen , Neil Binkley , John Schousboe , Diane Krueger
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Abstract

Introduction: Bone density measured using dual-energy X-ray absorptiometry (DXA) volume, performance site and interpreters have changed in the US since 2005. The purpose of this report is to provide updated trends in DXA counts, rates, place of service and interpreter specialty for the Medicare fee-for-service population.

Methods: The 100 % Medicare Physician/Supplier Procedure Summary Limited Data Set between 2005–2019 was used. DXA counts and annual rates per 10,000 Medicare beneficiaries were calculated. Annual distributions of scan performance location, provider type and interpreter specialty were described. Place of service trends (significance assigned at p < 0.05) of the mean annual share of DXA utilization were identified using linear regression.

Results: Annual DXA use per 10,000 beneficiaries peaked in 2008 at 832, declined to 656 in 2015 then increased (p < 0.001) by 38 per year to 807 in 2019. From 2005 to 2019 DXA performance in office settings declined from 70.7 % to 47.2 %. Concurrently, outpatient hospital (OH) DXA increased from 28.6 % to 51.7 %. In 2005, 43.5 % of DXAs were interpreted by radiologists. This increased (p < 0.001) in the office and OH, averaging 0.3 and 2.0 percentage points per year respectively, reaching 73.5 % in 2019. Interpretation by most non-radiologist specialties declined (p < 0.001).

Conclusions: From 2005–2019, total DXA use among Medicare beneficiaries declined reaching a nadir in 2015 then returned to 2005 levels by 2019. Office DXA declined since 2005 with 51.7 % of all scans now occurring in an OH setting. The proportion of DXAs interpreted by radiologists increased over time, reaching 73.5 % in 2019.

2005-2019年医疗保险受益人的双能x射线吸收仪趋势
目的采用双能x线骨密度仪(DXA)测量骨密度,2005年以来骨密度、骨密度、骨密度、骨密度、骨密度等指标发生了变化。本报告的目的是为医疗保险按服务收费人群提供DXA计数、费率、服务地点和口译专业方面的最新趋势。方法使用2005-2019年100%医疗保险医师/供应商程序摘要有限数据集。计算了每10,000名医疗保险受益人的DXA计数和年费率。描述了扫描性能位置、提供商类型和解释器专业的年分布。服务地点趋势(重要性赋于p <采用线性回归方法确定了DXA年平均利用率的0.05)。结果每万名受益人每年使用DXA的次数在2008年达到832次的峰值,2015年下降到656次,然后增加(p <0.001),每年减少38个,到2019年达到807个。从2005年到2019年,DXA在办公环境中的表现从70.7%下降到47.2%。同时,门诊医院(OH) DXA从28.6%增加到51.7%。2005年,43.5%的dxa是由放射科医生解释的。这增加了(p <0.001),平均年增长率分别为0.3和2.0个百分点,2019年达到73.5%。大多数非放射科专业的口译下降(p <0.001)。从2005年到2019年,医疗保险受益人使用DXA的总量在2015年达到最低点,然后在2019年恢复到2005年的水平。Office DXA自2005年以来有所下降,现在51.7%的扫描发生在OH设置中。放射科医生解读dxa的比例随着时间的推移而增加,2019年达到73.5%。
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来源期刊
Journal of Clinical Densitometry
Journal of Clinical Densitometry 医学-内分泌学与代谢
CiteScore
4.90
自引率
8.00%
发文量
92
审稿时长
90 days
期刊介绍: The Journal is committed to serving ISCD''s mission - the education of heterogenous physician specialties and technologists who are involved in the clinical assessment of skeletal health. The focus of JCD is bone mass measurement, including epidemiology of bone mass, how drugs and diseases alter bone mass, new techniques and quality assurance in bone mass imaging technologies, and bone mass health/economics. Combining high quality research and review articles with sound, practice-oriented advice, JCD meets the diverse diagnostic and management needs of radiologists, endocrinologists, nephrologists, rheumatologists, gynecologists, family physicians, internists, and technologists whose patients require diagnostic clinical densitometry for therapeutic management.
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