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Trends and Factors Associated With Peripheral Vascular Interventions for the Treatment of Claudication From 2011 to 2022: A National Medicare Cohort Study.
Dun, Chen; Stonko, David P; Bose, Sanuja; Keegan, Alana C; McDermott, Katherine M; Rumalla, Kranti C; Black, James H; Kalbaugh, Corey A; Makary, Martin A; Hicks, Caitlin W.
Afiliación
  • Dun C; Biomedical Informatics and Data Science Johns Hopkins University School of Medicine Baltimore MD.
  • Stonko DP; Department of Surgery Johns Hopkins University School of Medicine Baltimore MD.
  • Bose S; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery Johns Hopkins University School of Medicine Baltimore MD.
  • Keegan AC; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery Johns Hopkins University School of Medicine Baltimore MD.
  • McDermott KM; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery Johns Hopkins University School of Medicine Baltimore MD.
  • Rumalla KC; Department of Surgery Sinai Hospital of Baltimore Baltimore MD USA.
  • Black JH; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery Johns Hopkins University School of Medicine Baltimore MD.
  • Kalbaugh CA; Department of Surgery Johns Hopkins University School of Medicine Baltimore MD.
  • Makary MA; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery Johns Hopkins University School of Medicine Baltimore MD.
  • Hicks CW; Department of Epidemiology and Biostatistics Indiana University School of Public Health- Bloomington Bloomington IN USA.
J Am Heart Assoc ; 13(14): e033463, 2024 Jul 16.
Article en En | MEDLINE | ID: mdl-38958132
ABSTRACT

BACKGROUND:

Previous cross-sectional studies have identified wide practice pattern variations in the use of peripheral vascular interventions (PVIs) for the treatment of claudication. However, there are limited data on longitudinal practice patterns. We aimed to describe the temporal trends and charges associated with PVI use for claudication over the past 12 years in the United States. METHODS AND

RESULTS:

We conducted a retrospective analysis using 100% Medicare fee-for-service claims data to identify all patients who underwent a PVI for claudication between January 2011 and December 2022. We evaluated the trends in utilization and Medicare-allowed charges of PVI according to anatomic level, procedure type, and intervention settings using generalized linear models. Multinomial logistic regressions were used to evaluate factors associated with different levels and types of PVI. We identified 599 197 PVIs performed for claudication. The proportional use of tibial PVI increased 1.0% per year, and atherectomy increased by 1.6% per year over the study period. The proportion of PVIs performed in ambulatory surgical centers/office-based laboratories grew at 4% per year from 12.4% in 2011 to 55.7% in 2022. Total Medicare-allowed charges increased by $11 980 035 USD/year. Multinomial logistic regression identified significant associations between race and ethnicity and treatment setting with use of both atherectomy and tibial PVI.

CONCLUSIONS:

The use of tibial PVI and atherectomy for the treatment of claudication has increased dramatically in in ambulatory surgical center/office-based laboratory settings, non-White patients, and resulting in a significant increase in health care charges. There is a critical need to improve the delivery of value-based care for the treatment of claudication.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicare / Claudicación Intermitente Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicare / Claudicación Intermitente Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido