Survey finds CTA use has surged since 2001

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Driven by dramatic growth in chest exams and the number of studies performed in the emergency department (ED), utilization of CT angiography (CTA) exams in the Medicare population has skyrocketed over the past 13 years, according to new research from the Harvey L. Neiman Health Policy Institute.

In a study published online July 22 in the Journal of Vascular and Interventional Radiology, a Neiman team led by Dr. Anand Prabhakar reported that the total number of CTA exams in the Medicare fee-for-service population increased from 64,846 in 2001 to 1,709,088 in 2014.

Growth in overall volumes and in per-beneficiary utilization was found across all types of CTA services and in major sites of service. The greatest gains were in chest CTA studies and for CTA services provided in the ED, according to the researchers' analysis of aggregated Medicare fee-for-service claims data.

Chest CTA services surged from 36,984 studies in 2001 to reach 914,086 exams in 2014, according to the team. In 2013, 25.4 chest CTA studies were ordered per 1,000 Medicare enrollees, up from 1.2 in 2001. In addition, the percentage of CTA studies performed in the ED climbed from 11% in 2001 to 28% in 2014.

"With further advances in CT technology such as dual-source imaging, we anticipate this trend to continue as CTA exams continue to provide information previously only available through catheter-directed angiography," Prabhakar said in a statement.

In other findings, the total number of CTA exams per 1,000 Medicare enrollees reached 4.6 in 2013, up from 2.1 in 2001. Radiologists also remain the dominant providers of CTA exams, according to the group.

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