利用机会性CT量化骨密度筛查的机会和经济价值:医疗保险数据库分析

IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Soterios Gyftopoulos MD, MBA , Casey E. Pelzl MPH , Connie Y. Chang MD
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引用次数: 0

摘要

目的本研究的目的是确定机会性CT骨密度筛查在提高筛查率和避免成本方面的潜在影响。方法分析数据取自2015-2022年医保5%研究可识别文件。所有相关身体区域的双能x线吸收仪(DEXA)程序以及对比和/或非对比CT程序均使用现行程序术语代码进行识别。研究结果包括骨质疏松筛查成像和髋部或脊柱脆性骨折。计算了潜在的年度成本避免。结果共确定2,897,040名受益人进行分析,其中584,391名受益人(20.2%)接受了DEXA, 658,703名受益人(22.7%)未接受DEXA但至少接受了一次包括L1椎体的CT检查,446,706名(67.8%)未接受DEXA, 211,997名(32.2%)进行了对比。在非对比组和对比组中,1年内分别有2766例(0.6%)和613例(0.3%)髋部骨折,23889例(5.3%)和5222例(2.5%)脊柱脆性骨折。仅使用非对比CT研究,骨质疏松筛查率将增加76%,使用所有CT研究,骨质疏松筛查率将增加113%。如果仅使用非对比CT来识别骨质疏松症,并且100%的符合条件的受益人成功实施治疗,那么该研究人群将节省超过1700万美元的医疗费用。如果使用任何CT,本研究人群的潜在年度成本节约将接近1亿美元,所有2023年医疗保险服务收费受益人的成本节约将达到25亿美元。结论实施机会性CT骨密度筛查可能会对患者的护理和经济产生重大影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quantifying the Opportunity and Economic Value of Bone Density Screening Using Opportunistic CT: A Medicare Database Analysis

Purpose

The aim of this study was to determine the potential impact of opportunistic CT bone density screening in terms of increasing screening rates and cost avoidance.

Methods

The analytic dataset was extracted from the Medicare 5% Research Identifiable Files (2015-2022). All dual-energy x-ray absorptiometry (DEXA) procedures and contrast and/or noncontrast CT procedures of pertinent body regions were identified using Current Procedural Terminology codes. Outcomes of interest included osteoporosis screening imaging and fragility fractures of the hip or spine. Potential annual cost avoidance was calculated.

Results

In total, 2,897,040 beneficiaries were identified for analysis, of whom 584,391 beneficiaries (20.2%) underwent DEXA and 658,703 beneficiaries (22.7%) did not undergo DEXA but did undergo at least one CT examination that included the L1 vertebral body, 446,706 (67.8%) without and 211,997 (32.2%) with contrast. In the noncontrast and contrast CT groups, there were 2,766 (0.6%) and 613 (0.3%) hip and 23,889 (5.3%) and 5,222 (2.5%) spine fragility fractures within 1 year of CT. The osteoporosis screening rate would increase by 76% using only noncontrast CT studies and by 113% using all CT studies. If only noncontrast CT was used to identify osteoporosis and treatment was successfully implemented in 100% of eligible beneficiaries, this study population would see a medical cost avoidance in excess of $17 million. If any CT was used, potential annual cost avoidance for this study’s population would be nearly $100 million and $2.5 billion for all 2023 Medicare fee-for-service beneficiaries.

Conclusions

Implementing opportunistic CT bone density screening could potentially have a substantial patient care and economic impact.
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来源期刊
Journal of the American College of Radiology
Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
6.30
自引率
8.90%
发文量
312
审稿时长
34 days
期刊介绍: The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.
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