Regional variability of cardiovascular magnetic resonance access and utilization in the United States.

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Jennifer M Li, David R Ho, Nazia Husain, Robert W Biederman, J Paul Finn, Anthon R Fuisz, Ibrahim M Saeed, Kim-Lien Nguyen
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引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

美国心血管磁共振成像的获取和利用的地区差异。
背景:临床指南和科学数据越来越多地支持适当使用心血管磁共振 (CMR) 成像。美国采用 CMR 的程度仍不清楚。本观察分析旨在了解美国的 CMR 实践模式:方法:使用了心血管磁共振学会(SCMR)的委托报告、CMR 中心已有的调查数据以及美国疾病控制和预防中心的社会经济和冠心病数据。执行CMR的成像中心的位置基于2018年医疗保险报销单。对 2017-2019 年特定中心的调查数据进行了二次分析,这些数据是由 SCMR 美国宣传小组委员会成员为提高质量而收集的。确定了每百万人中开具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 家成像中心向医疗保险和医疗补助服务中心(Center for Medicare & Medicaid Services)开具了 CMR 服务账单,112 家(共 155 家)独特的 CMR 中心对调查做出了回应。2018 年,几乎所有 50 个州都提供 CMR 服务。每百万医疗保险受益人中,明尼苏达州的 CMR 中心数量最多(每百万人中有 52.6 个中心),缅因州最少(每百万人中有 4.4 个)。在美国医疗保险受益人中,CMR 中心的总密度为每百万人 16 个。68%(112 位调查对象中的 83 位)的调查对象是心脏病专家,28% 是放射科专家。在 72% 的中心中,学术医疗保健系统进行了 81-100% 的 CMR 检查。2017-2019年间,高容量中心(每年>500次扫描)的数量增加了7个。2019年,53%的中心被认为是高容量中心,平均拥有19年的经验。中心执行结论:尽管几乎所有 50 个州的CMR数量和可用性都在增加,但CMR的可及性仍存在地域差异。通过宣传来提高可及性,并通过创新来缩短成像时间和降低检查复杂性,这些都有可能提高 CMR 技术的采用率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
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