Long-Term Trends in Home Respiratory Medical Equipment among U.S. Medicare Patients, 2013-2019.
Long-Term Trends in Home Respiratory Medical Equipment among U.S. Medicare Patients, 2013-2019.
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2013-2019 年美国医疗保险患者家庭呼吸医疗设备的长期趋势。
DOI：
10.1164/rccm.202202-0238le
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发表时间：
2022
影响因子：
24.7
通讯作者：
Au,DavidH
中科院分区：
文献类型：
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作者：
Duan,KevinI;Wong,EdwinS;Liao,JoshuaM;Sabbatini,AmberK;Au,DavidH
我们分析了2013年至2019年所有公开的全国医疗DME数据。DME数据在2013年之前没有公开。我们通过医疗保健通用程序编码系统代码识别呼吸DME产品（参见在线补充中的表E1）。我们分析了CBP中包含的所有呼吸DME（不包括面罩、管路和过滤器等配件）。我们的主要结果是医疗保险和医疗补助服务中心（CMS）每种产品签约的DME供应商数量。次要结果是每个DME供应商的索赔和使用每个DME产品的Medicare受益人的百分比。我们描述了2013年至2019年期间每种DME产品结果的趋势和百分比变化。本研究不符合华盛顿大学机构审查委员会设定的人类受试者研究定义，无需审查。使用Stata版本14（StataCorp）进行分析。ResultsThe三个最高容量的呼吸DME产品是固定式氧气浓缩器，持续气道正压通气（CPAP）设备，和气态便携式氧气。在2013年至2019年期间，固定式制氧机的DME供应商数量从7，488家减少到4，656家（-38%），CPAP设备从7，197家减少到4，947家（-31%），气态便携式氧气从7，107家减少到4，321家（-39%）（图1）。每个供应商的索赔从1，146增加到1，370，固定式制氧机（+ 19%），CPAP设备从408增加到911（+ 123%），气态便携式氧气从521增加到637（+ 22%）。使用呼吸DME的医疗保险受益人的百分比下降了固定式氧气浓缩器（从3.2%到2.3%变化了-28%）和气态便携式氧气（从1.5%到1.1%变化了-27%），但CPAP设备增加了（从1.4%到2.0%增加了43%）。
MethodsWe analyzed all publicly available nationwide Medicare DME data from 2013 to 2019 (4). DME data were not publicly available before 2013. We identified respiratory DME products by Healthcare Common Procedure Coding System codes (see Table E1 in the online supplement). We analyzed all respiratory DME included in the CBP (excluding accessories such as masks, tubing, and filters). Our primary outcome was the number of DME suppliers contracted by the Centers for Medicare and Medicaid Services (CMS) per product. Secondary outcomes were claims per DME supplier and percentage of Medicare beneficiaries using each DME product. We described trends and percentage changes in outcomes for each DME product between 2013 and 2019. This study did not meet the definition of human subjects research set by the University of Washington institutional review board and did not require review. Analysis was conducted using Stata version 14 (StataCorp).ResultsThe three highest volume respiratory DME products were stationary oxygen concentrators, continuous positive airway pressure (CPAP) devices, and gaseous portable oxygen. Between 2013 and 2019, the number of DME suppliers decreased from 7,488 to 4,656 for stationary oxygen concentrators (− 38%), from 7,197 to 4,947 for CPAP devices (− 31%), and from 7,107 to 4,321 for gaseous portable oxygen (− 39%)(Figure 1). Claims per supplier increased from 1,146 to 1,370 for stationary oxygen concentrators (+ 19%), from 408 to 911 for CPAP devices (+ 123%), and from 521 to 637 for gaseous portable oxygen (+ 22%). The percentage of Medicare beneficiaries using respiratory DME decreased for stationary oxygen concentrators (− 28% change from 3.2% to 2.3%) and gaseous portable oxygen (− 27% change from 1.5% to 1.1%) but increased for CPAP devices (+ 43% from 1.4% to 2.0%).