Nationwide Trends in Tube-Related Genitourinary Interventions for Medicare Beneficiaries |
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| Institution: | 1. Department of Radiology, Ohio State University Wexner Medical Center, Columbus, Ohio;2. Northwest Radiology, St Vincent Health, Indianapolis, Indiana;3. Harvey L. Neiman Health Policy Institute, Reston, Virginia;4. Executive Director, Harvey L. Neiman Health Policy Institute, Reston, Virginia;5. Director of Scholarly Activity/Research, Department of Radiology, Ohio State University, Wexner Medical Center, Columbus, Ohio;1. Department of Radiology, Boston Medical Center, Boston, Massachusetts;2. Boston University School of Medicine, Boston, Massachusetts;3. Georgetown University School of Medicine, MedStar Health Research Institute, Hyattsville, Maryland;4. Department of Ophthalmology, Boston Medical Center, Boston, Massachusetts;5. Department of Urology, Georgetown University School of Medicine, Washington, DC;1. Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri and is a Co-founder of Coordinate Medical Systems;2. Division of Medical Physics—Mayo Clinic, Scottsdale, Arizona;3. American College of Radiology, Reston, Virginia;4. American College of Radiology, Reston, Virginia;1. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;2. Department of Radiology, University of Colorado—Anschutz Medical Campus, Denver, Colorado;3. Department of Orthopedic Surgery and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;4. Director of Musculoskeletal Ultrasound and Fellowship Director for Musculoskeletal Imaging and Intervention, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;1. Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts;2. Harvard Medical School, Boston, Massachusetts;1. Abdominal Imaging Fellowship Director, Department of Radiology, New York Presbyterian-Columbia University Irving Medical Center, New York, New York;2. Vice Chair of Academic Affairs and Faculty Development, Department of Radiology, New York Presbyterian-Weill Cornell Medicine, New York, New York;3. Director of Comparative Effectiveness and Outcomes Research, Departments of Radiology and Surgery, NYU Grossman School of Medicine, New York, New York;4. Department of Abdominal Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas;5. Department of Radiology, University of Michigan, Ann Arbor, Michigan;6. Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio;7. Department of Radiology, Mayo Clinic, Rochester, Minnesota;8. Chief of Body MRI and the Body MRI Fellowship Director, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas;9. Director of FPO Outpatient Imaging Services, Departments of Radiology and Surgery, NYU Grossman School of Medicine, New York, New York;10. Vice Chair of Education, Department of Radiology, The University of Alabama, Birmingham, Alabama;11. Chairman of Radiology, Department of Radiology, University of Washington, Seattle, Washington;12. Department of Radiology, Stanford University Medical Center, Palo Alto, California;13. Chairman of Radiology, Department of Radiological Sciences, University of California, Irvine, Orange, California;14. Vice Chair of Quality, Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;15. Cross-Sectional Body Imaging Fellowship Director, Department of Radiology, John Hopkins Medicine, Baltimore, Maryland |
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| Abstract: | PurposeTo evaluate national trends in tube-related genitourinary interventions, with specific attention to primary operator specialty.MethodsUsing a 5% national sample of Medicare claims data from 2005 to 2015, all claims associated with nephrostomy tube, nephro-ureteral tube, and ureteral stent placement and exchange were identified. The annual volume of the nine billable procedures were analyzed to evaluate trends in the number of procedures performed and primary operator specialty over time. The Charleston Comorbidity Index (CCI) was used to evaluate patient comorbidities and to determine differences in patient populations treated by interventional radiologists and urologists.ResultsThe total volume of tube-related genitourinary interventions has increased over the course of the study period, representing 455.0 services per 100,000 Medicare Fee-for-Service beneficiaries in 2005 to 607.2 services in 2015, an increase of 33.4%. Interventional radiologists performed the majority of all procedures in all procedure types and for each year (>90%) with the exception of nephro-ureteral catheter placement or ureteral stent placement, for which urologists performed the overwhelming majority of procedures each year (>85%). Interventional radiologists performed 63% of their total number of procedures on patients with a CCI = 3 or higher, and urologists performed 42% of their total number of procedures on patients with a CCI = 3 or higher (P < .01).ConclusionTube-related genitourinary interventions have demonstrated persistent growth over the 2005 to 2015 decade. Interventional radiologists are the dominant providers for the majority of these interventions compared with urologists while delivering care to a patient population with a higher number of comorbidities. |
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| Keywords: | Genitourinary interventions interventional radiology Medicare urology utilization |
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