Geographic variation and trends in carotid imaging among medicare beneficiaries, 2001 to 2006.
Abstract
<h4>Background</h4>Diagnostic imaging among Medicare beneficiaries is an important
contributor to rising health care costs. We examined temporal trends and geographic
variation in the use of carotid ultrasound, carotid magnetic resonance angiography
(MRA), and carotid x-ray angiography.<h4>Methods and results</h4>Analysis of a 5%
national sample of claims from the Centers for Medicare and Medicaid Services for
1999 through 2006. Patients were 65 years or older and underwent carotid ultrasound,
carotid MRA, carotid x-ray angiography, or a carotid intervention. The main outcome
measures were annual age-adjusted rates of carotid imaging and interventions and factors
associated with the use of carotid imaging. Rates of imaging increased by 27%, from
98.2 per 1000 person-years in 2001 to 124.3 per 1000 in 2006. Rates of carotid ultrasound
increased by 23%, and rates of MRA increased by 66%. Carotid intervention rates decreased
from 3.6 per 1000 person-years in 2001 to 3.1 per 1000 person-years in 2006. In 2006,
rates of carotid ultrasound were lowest in the New England, Mountain, and West North
Central regions and highest in the Middle Atlantic and South Atlantic regions. Regional
differences persisted after adjustment for patient demographic characteristics, history
of vascular disease and other comorbid conditions, and study year.<h4>Conclusions</h4>From
2001 through 2006, there was substantial growth and variation in the use of carotid
imaging, including a marked increase in the use of MRA, and a decrease in the overall
rate of carotid intervention.
Type
Journal articleSubject
Carotid ArteriesHumans
Cardiovascular Diseases
Magnetic Resonance Angiography
Coronary Angiography
Ultrasonography
Age Factors
Comorbidity
Cost of Illness
Aged
Aged, 80 and over
Mid-Atlantic Region
New England
Female
Male
Permalink
https://hdl.handle.net/10161/22911Published Version (Please cite this version)
10.1161/circoutcomes.110.950279Publication Info
Curtis, LH; Greiner, MA; Patel, MR; Duncan, PW; Schulman, KA; & Matchar, DB (2010). Geographic variation and trends in carotid imaging among medicare beneficiaries, 2001
to 2006. Circulation. Cardiovascular quality and outcomes, 3(6). pp. 599-606. 10.1161/circoutcomes.110.950279. Retrieved from https://hdl.handle.net/10161/22911.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Lesley H. Curtis
Professor in Population Health Sciences
Lesley H. Curtis is Professor in the Departments of Population Health Sciences and
Medicine in the Duke School of Medicine and was inaugural chair of the Department
of Population Health Sciences. A health services researcher by training, Dr. Curtis
is an expert in the use of health care and Medicare claims data for health services
and clinical outcomes research, and a leader in national data quality efforts. Dr.
Curtis has led the linkage of Medicare claims with seve
Pamela Woods Duncan
Adjunct Professor in the Department of Orthopaedic Surgery
Dr. Duncan is a nationally and internationally renowned physical therapist and epidemiologist,
who is considered one of the world’s leading experts and consultants in the
selection of outcome measures for stroke clinical trials. A recognized leader and
innovator in stroke rehabilitation; she has dedicated her career to elevating the
science of rehabilitation, improving the physical function of the elderly, and improving
stroke care and outcomes. Most importantly her passion is to cont
David Bruce Matchar
Professor of Medicine
My research relates to clinical practice improvement - from the development of clinical
policies to their implementation in real world clinical settings. Most recently my
major content focus has been cerebrovascular disease. Other major clinical areas in
which I work include the range of disabling neurological conditions, cardiovascular
disease, and cancer prevention. Notable features of my work are: (1) reliance on
analytic strategies such as meta-analysis, simulation, decision analy
Manesh Raman Patel
Richard Sean Stack, M.D. Distinguished Professor
Manesh Patel is the Chief of the Division of Cardiology and the Division of Clinical
Pharmacology. His clinical interests include diagnostic and interventional coronary
angiography, peripheral angiography and endovascular intervention. His is involved
in several clinical trials involving patients with cardiovascular disease and in cardiac
imaging. He is also the Chair of the American College of Cardiology Task Force for
Appropriate Use Criteria for Cardiovascular Procedures and
Kevin Alan Schulman
Adjunct Professor in the Department of Medicine
Kevin A. Schulman, MD, MBA, is a professor of medicine and the Gregory Mario and Jeremy
Mario Professor of Business Administration (2010 - 2016) at Duke University. He is
a visiting professor of business administration at Harvard Business School. He holds
several leadership appointments at Duke. He is an associate director of the Duke Clinical
Research Institute in the School of Medicine, the country's largest academic clinical
research organization. In Duke's Fuqua School of Business, he s
This author no longer has a Scholars@Duke profile, so the information shown here reflects
their Duke status at the time this item was deposited.
Alphabetical list of authors with Scholars@Duke profiles.

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info