Longitudinal trends in use of bone mass measurement among older Americans, 1999-2005
Longitudinal trends in use of bone mass measurement among older Americans, 1999-2005
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DOI：
10.1359/jbmr.080232
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发表时间：
2008-07-01
影响因子：
6.2
通讯作者：
Delzell, Elizabeth
中科院分区：
文献类型：
--
作者：
Curtis, Jeffrey R.;Carbone, Laura;Delzell, Elizabeth
骨量测量（BMM）可用于识别低骨量人群，这些人群骨折风险增加。由于越来越重视预防性服务，如骨质疏松症筛查，我们评估了医疗保险受益人中BMM的趋势。我们研究了1999-2005年期间5%的65岁以上医疗保险受益人样本。我们确定了在设施和非设施环境中进行的BMM测试的索赔，评估了这些测试的使用的时间趋势，并描述了提交索赔的医生的每个专业的测试比例。我们还评估了多次测试的个人之间的系列测试模式。汇总了所有年份的索赔数据，以描述曾经接受过测试的人口比例。从1999年到2005年，中央DXA的使用增加了50%，外周DXA的使用下降了。增加最多的是内科医生、家庭医生和妇科医生。1999年，接受检测的65岁妇女比例为8.4%; 2005年增加到12.9%。男子的相应比例分别为0.6%和1.7%。40%至73%的人接受中央DXA重新测试，大多数在类似的2年的时间间隔。汇总所有年份的白人和黑人数据，30.0%的女性和4.4%的男性至少接受过一次中央DXA。我们的结论是，虽然使用DXA稳步增加，从1999年至2005年，只有类似的30%的女性和4%的男性至少65岁的中心DXA研究。考虑到中心DXA评估骨质疏松性骨折风险的重要性，增加中心DXA使用以检测高危人群的策略是必要的。
Bone mass measurement (BMM) is useful to identify persons with low bone mass who are at increased risk for fracture. Given the increased emphasis that is being placed on preventive services such as screening for osteoporosis, we evaluated trends in BMM among Medicare beneficiaries. We studied a 5% sample of Medicare beneficiaries >= 65 yr of age in 1999-2005. We identified claims for BMM tests performed in both facility and nonfacility settings, evaluated temporal trends in use of these tests, and described the proportion of tests attributable to each specialty of physicians submitting claims. We also assessed patterns of serial testing among individuals who were tested more than once. Claims data from all years were pooled to describe the proportion of persons in the population ever tested. From 1999 to 2005, use of central DXA increased by similar to 50%, and use of peripheral DXA declined. The greatest increases in central DXA occurred among internists, family practitioners, and gynecologists. In 1999, the proportion of 65-yr-old women tested was 8.4%; this increased to 12.9% in 2005. Corresponding proportions for men were 0.6% and 1.7%, respectively. Between 40% and 73% of persons receiving central DXA were retested, most at similar to 2-yr intervals. Aggregating data across all years for whites and blacks, 30.0% of women and 4.4% of men underwent central DXA at least once. We conclude that, although use of DXA steadily increased from 1999 to 2005, only similar to 30% of women and 4% of men at least 65 yr old had a central DXA study. Given the importance of central DXA to assess the risk of osteoporotic fractures, strategies to increase central DXA use to test at-risk persons are warranted.