Temporal Trends and Geographic Accessibility to Cardiac Magnetic Resonance (CMR) Readers Across the United States: An Analysis of Medicare Part B Data.
Ahmad El Yaman, Ahmed Sayed, Maria Alwan, Asim Shaikh, Mahmoud Al Rifai, Maan Malahfji, Dipan J Shah, Ibrahim M Saeed, Chiara Bucciarelli-Ducci, Mouaz H Al-Mallah
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Abstract
Background: Cardiac Magnetic Resonance (CMR) has a growing role in the diagnosis and management of cardiac disease. However, there is little recent data on the availability of CMR physicians (readers) in the US.
Objective: To demonstrate the geographic proximity and accessibility of patients to CMR services and CMR physicians across the US.
Methods: Using Medicare Part B data in 2022, we analyzed the number and characteristics of CMR readers, their geographical location, and the volume of CMR scans between 2013 and 2022. CMR procedure types were identified using HCSPC codes 75557, 75559, 75561, and 75563.
Results: Among Medicare Beneficiaries in 2022, there were 48,622 CMR scans, up from 17,944 in 2013 (170.9% increase). The lowest scans and reader density were in West Virginia (125.8 procedures and 2.2 readers per million beneficiaries respectively) and the highest in the District of Columbia (4,566.5 procedures and 52.9 readers per million beneficiaries respectively). No CMR scans were billed in Puerto Rico. Among states and territories that billed for CMR, 50.8 million US citizens were located more than 50 miles from CMR readers and 18.1 million were located more than 100 miles away. Out of 991 readers, 51.9% were radiologists and 48.1% were cardiologists. The median number of scans interpreted by cardiologists was higher than radiologists across all graduation year intervals, and male and female readers interpreted a similar median number of scans. The relative proportion of female readers increased markedly when assessing physicians who graduated after 2010.
Conclusion: This study highlights significant geographic disparities and barriers to accessing CMR in the US.
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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