Utilization of radiologic services in different payment systems and patient populations
Utilization of radiologic services in different payment systems and patient populations
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DOI：
10.1148/radiology.200.1.8657910
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发表时间：
1996-07-01
期刊：
影响因子：
19.7
通讯作者：
Sunshine, JH
中科院分区：
文献类型：
--
作者：
Burkhardt, JH;Sunshine, JH
目得：为了报告基于人口的利用率和他们的变异性之间和人群内，地理区域，和不同的支付系统的诊断放射学和放射肿瘤学procedure.MATERIALS和METHODS：汇总索赔数据从四个来源获得多达九个放射方式。这些数据涵盖医疗保险，健康维护组织（HMO）和传统保险。有些来源的数据分为四个年龄组。所有的放射服务，包括那些由nonradiologists提供的，included.RESULTS：平均每年门诊诊断放射利用率范围从570程序每1,000非老年人在HMO设置为1,970每1,000医疗保险登记。放射肿瘤利用率增加了11个程序每1,000人的HMO人口率和260每1,000人的医疗保险人口率。在医疗保险数据中，第25百分位数州的诊断放射学利用率是第75百分位数州的78%。在一个小样本的HMO，第25百分位的HMO率为45%的第75百分位HMO率。结论：利用率存在很大的差异。国家或地区的平均值并不能很好地指导特定患者人群的使用率，不应作为标准。只有来自患者群体的实际数据才有可能为放射科医生提供相当准确的未来利用率预测。
PURPOSE: To report population-based utilization rates and their variability across and within populations, geographic areas, and different payment systems for diagnostic radiology and radiation oncology procedures.MATERIALS AND METHODS: Aggregated claims data were obtained from four sources for up to nine radiologic modalities. The data cover Medicare, health maintenance organizations (HMOs), and conventional insurance. For some sources, the data were separated into four age groups. All radiologic services, including those provided by nonradiologists, were included.RESULTS: Average annual ambulatory diagnostic radiology utilization rates ranged from 570 procedures per 1,000 nonelderly persons in an HMO setting to 1,970 per 1,000 for Medicare enrollees. Radiation oncology utilization rate added 11 procedures per 1,000 to the HMO population rate and 260 per 1,000 to the Medicare population rate. In the Medicare data, the diagnostic radiology utilization rate in the 25th percentile state was 78% of the rate in the 75th percentile state. In a small sample of HMOs, the 25th percentile HMO rate was 45% of the 75th percentile HMO rate.CONCLUSION: Much variability exists in utilization rates. National or regional averages are not a good guide to the utilization rates in a specific patient population and should not be taken as norms. Only actual data from a patient population are likely to provide radiologists with fairly accurate predictions of their future utilization rates.