20 因外周动脉疾病而接受外周血管介入治疗的医疗保险患者的特征因门诊服务地点而异

IF 2.1 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Journal of Clinical and Translational Science Pub Date : 2024-04-03 DOI:10.1017/cts.2024.39
Terrence Tsou, Chen Dun, Caitlin Hicks
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引用次数: 0

摘要

目的/目标:血管内外周血管介入治疗(PVI)越来越多地被用于治疗外周动脉疾病(PAD)。我们旨在评估在非卧床手术中心和办公室实验室(ASC/OBL)与门诊医院(医院)服务场所接受 PVI 患者的特征。方法/研究对象:我们使用 2017 年 1 月 1 日至 2022 年 12 月 31 日期间 100% 的医疗保险付费服务索赔数据进行了回顾性分析。我们使用当前程序术语(CPT)代码来识别接受血管成形术、支架植入术或动脉粥样硬化切除术的患者。患者的人口统计数据来自医疗保险主受益人摘要档案,相关合并症和 PVI 适应症则使用国际疾病分类 (ICD)-10 代码进行识别。我们使用患者的邮政编码来确定患者的居住密度和地区。我们使用服务地点代码来确定 PVI 是在 ASC/OBL 还是在医院进行的。结果采用描述性统计进行分析。结果/预期结果:在 817,241 名接受 PVI 治疗的 PAD 患者中,461,068 人(56.4%)在 ASC/OBL 接受了治疗。与在医院接受治疗的患者相比,在 ASC/OBLs 接受 PVI 治疗的患者更可能是老年人、女性、非白种人、合并症(终末期肾病、糖尿病、高血压和任何吸烟史)较少的患者(所有患者,P<0.001)。在 ASC/OBLs 接受治疗的患者更多居住在城市(相对于农村)、南部和西部(均为 P<0.001)。PVI的适应症主要是危及肢体缺血的慢性肢体缺血,各组之间的临床情况相似(77.1% vs. 76.2%)。随着时间的推移,服务地点发生了重大变化:2017年,少数(47.6%)PVI在ASC/OBL进行,而2022年,大多数(64.7%)PVI在ASC/OBL进行(P<0.001)。讨论/意义:与在医院门诊环境中接受治疗的患者相比,在ASC/OBLs接受治疗的患者医疗复杂程度较低。需要进一步研究患者特征与其他因素(如报销)之间的差异是否会导致在 ASC/OBL 进行的 PVI 随时间推移而增加。
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20 Characteristics of Medicare patients receiving peripheral vascular interventions for peripheral artery disease differ by outpatient site of service
OBJECTIVES/GOALS: Endovascular peripheral vascular interventions (PVIs) are increasingly utilized for the treatment of peripheral artery disease (PAD). We aimed to assess characteristics of patients receiving PVI at ambulatory surgical centers and office-based labs (ASC/OBL) versus the outpatient hospital (hospital) site of service. METHODS/STUDY POPULATION: We performed a retrospective analysis using 100% Medicare fee-for-service claims data between January 1, 2017 and December 31, 2022. We used Current Procedural Terminology (CPT) codes to identify patients undergoing angioplasty, stenting, or atherectomy. Patient demographics were collected from the Medicare Master Beneficiary Summary File and associated comorbidities and PVI indications were identified using International Classification of Disease (ICD)-10 codes. We used patient ZIP codes to determine patients’ residence densities and regions. We used site of service codes to determine whether PVI were performed in the ASC/OBL versus hospital. Results were analyzed with descriptive statistics. RESULTS/ANTICIPATED RESULTS: Of 817,241 patients undergoing PVI for PAD, 461,068 (56.4%) were treated in an ASC/OBL. Compared to patients treated in the hospital, patients receiving PVI at ASC/OBLs were more likely to be older, female, non-white race, with fewer comorbidities (end stage renal disease, diabetes, hypertension, and any history of tobacco use) (all, P<0.001). Patients treated in ASC/OBLs more frequently resided in urban (vs. rural) locations, and in the South and West (both, P<0.001). Indication for PVI was predominately chronic limb-threatening ischemia, and clinically similar between groups (77.1% vs. 76.2%). There was a significant change in site of service over time: a minority (47.6%) of PVIs were performed in the ASC/OBL in 2017, whereas the majority (64.7%) of PVIs were performed in the ASC/OBL in 2022 (P<0.001). DISCUSSION/SIGNIFICANCE: Patients treated in ASC/OBLs were less medically complex compared to those treated in the outpatient hospital setting. Further study is needed to examine whether differences in patient characteristics versus other factors (e.g. reimbursement) are driving the increase in PVIs performed in the ASC/OBL over time.
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来源期刊
Journal of Clinical and Translational Science
Journal of Clinical and Translational Science MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.80
自引率
26.90%
发文量
437
审稿时长
18 weeks
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