Assessing Cost-Effectiveness And Value As Imaging Grows: The Case Of Carotid Artery CT
Assessing Cost-Effectiveness And Value As Imaging Grows: The Case Of Carotid Artery CT
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DOI：
10.1377/hlthaff.2010.0046
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发表时间：
2010-12-01
期刊：
影响因子：
9.7
通讯作者：
Atlas, Scott W.
中科院分区：
文献类型：
--
作者：
Baker, Laurence C.;Afendulis, Christopher C.;Atlas, Scott W.
计算机断层扫描（CT）血管造影是一种成像检查，在诊断颈动脉狭窄方面比旧的检查更安全，更便宜-颈动脉狭窄是美国成年人中风的最常见原因。我们对2001年至2005年期间医疗保险数据的检查发现，大约20%的时间使用这种测试，它取代了旧的测试。然而，大多数新的使用构成了“增量”使用，在患者以前不会接受任何测试的情况下。我们没有发现任何证据表明CT血管造影术的发展导致更多的患者接受颈动脉疾病的治疗。作为旧程序的替代品，该测试的价值可能足以证明扩大使用是合理的。跟踪新兴技术的使用情况以鼓励有效使用至关重要，但在新工具有多种用途和信息不完整的情况下，这可能具有挑战性。
Computed tomographic (CT) angiography is an imaging test that is safer and less expensive than an older test in diagnosing narrowing of the carotid arteries-the most common cause of stroke in US adults. Our examination of Medicare data between 2001 and 2005 found that about 20 percent of the time this test was used, it substituted for the older test. The majority of new use, however, constituted "incremental" use, in cases where patients previously would not have received any test. We found no evidence that the growth in CT angiography led to more patients' being treated for carotid artery disease. The value of the test as a substitute for the older procedure may be enough to still justify expanding use. Tracking the uses of emerging technologies to encourage efficient use is essential, but it can be challenging in cases where new tools have multiple uses and information is incomplete.