Use of Lung Cancer Screening With Low-Dose Computed Tomography in the Medicare Population.
Use of Lung Cancer Screening With Low-Dose Computed Tomography in the Medicare Population.
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DOI：
10.1016/j.mayocpiqo.2018.12.003
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发表时间：
2019-03-01
期刊：
影响因子：
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通讯作者：
Goodwin, James S
中科院分区：
文献类型：
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作者：
Nishi, Shawn;Zhou, Jie;Goodwin, James S
目的：描述医疗保险和医疗补助服务中心(CMS)开始报销和筛查要求之前和之后的低剂量计算机断层扫描(LDCT)和全胸部计算机断层扫描(CT)的比率，并描述与接受低剂量CT相关的因素。方法和方法：在20%的全国样本中(2010年为3,887,430人，2015年为4,200,875人，2016年为4,145,542人)，对A和B部分未参加医保的联邦医疗保险参保人进行了回顾性横断面研究。结果是在2010年1月1日至2016年12月31日期间接受了LDCT和任何胸部CT。其他指标包括参与者的人口学特征和诊断，包括烟草使用的诊断。结果：55岁至77岁的LDCT参与者的数量在2015年至2016年初有所上升，然后趋于平稳。2016年，0.44%的参与者和2.21%的烟草使用诊断患者接受了LDCT筛查。从2010年1月1日到2016年12月31日，任何胸部CT(LDCT或诊断性)的比率都有所上升，其中大部分是由LDCT造成的。结论：在CMS批准肺癌筛查报销两年后，符合筛查条件的医疗保险人群中接受LDCT的比例不到5%。需要更多的工作来确定和修改LDCT筛查的障碍。
OBJECTIVE: To describe rates of low-dose computed tomography (LDCT) and all chest computerized tomography (CT) before and after Centers for Medicare and Medicaid Services (CMS) initiated reimbursement and requirements for screening and to describe factors associated with receipt of LDCT.PATIENTS AND METHODS: Retrospective cross-sectional study of Medicare enrollees aged 55 to 77 in Parts A and B Medicare without HMO enrollment in a 20% national sample (n=3,887,430 in 2010, 4,200,875 in 2015, and 4,145,542 in 2016). The outcomes were receipt of LDCT and any chest CT from January 1, 2010, to December 31, 2016. Other measures included enrollee demographic characteristics and diagnoses, including diagnoses of tobacco use.RESULTS: The number of enrollees aged 55 to 77 with LDCT rose throughout 2015 and early 2016, and then plateaued. In 2016, 0.44% of enrollees, and 2.21% of those with a tobacco-use diagnosis, underwent LDCT screening. There were increases in the rate of any chest CT (LDCT or diagnostic) between January 1, 2010 and December 31, 2016, and most of this was accounted for by LDCTs.CONCLUSIONS: Two years after CMS approval for lung cancer screening reimbursement, less than 5% of the Medicare population eligible for screening received LDCT. More work is required to identify and modify the barriers for LDCT screening.