Clinical InvestigationImaging and Diagnostic TestingTrends in echocardiography utilization in the Veterans Administration Healthcare System
Section snippets
Data sources
We used VA Patient Treatment Files and Outpatient Care Files to identify all echocardiograms performed between fiscal year 2000 and 2007. The Patient Treatment File contains discharge abstract data for all patients hospitalized in VA medical centers. Key data elements include patient demographics, admission dates, primary and secondary diagnoses, and procedures performed during hospitalization (eg, echocardiography) as defined by International Classification of Diseases Ninth Revision, Clinical
Patient characteristics
Between 2000 and 2007, a total of 1,159,725 echocardiograms were performed in the VA, with the annual number of echocardiograms ranging from 92,269 in 2000 to 195,767 in 2007 (Figure 1). During the same period, the number of patients receiving care increased from 1,341,071 in 2000 to 2,739,215 during 2007 (Figure 1).
Compared with VA users who did not receive echocardiograms, echocardiogram recipients were significantly older and more likely to be of white or black race (Table I). Not
Discussion
In an analysis of VA administrative data, we found that use of echocardiography doubled between 2000 and 2007. Interestingly, and in contrast to our expectation, echocardiography utilization remained relatively constant over our study period. Alternatively, we did find evidence that, since 2004, echocardiogram utilization may be accelerating and an increasing proportion of patients may be receiving multiple studies.
A number of our study findings merit further discussion. First, it is important
Conclusions
We found that, among VA users, the use of echocardiography doubled between 2000 and 2007 but that echocardiogram utilization remained relatively constant, providing a measure of reassurance for those concerned about rapid growth in the use of imaging studies. Alternatively, we did find evidence that, since 2004, echocardiogram utilization has been accelerating and repeated imaging of patients has been on the rise. There is a wide range of geographic variability in echocardiography utilization
Disclosures
Funding sources: Dr Okrah receives fellowship stipend and tuition support from the Cardiovascular Interdisciplinary Research Training Grant, Iowa Cardiovascular Center, University of Iowa Carver College of Medicine. Dr Cram has an appointment in the Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the Iowa City VA Medical Center, which is funded through the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and
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