Computed Tomography Utilization in the North Carolina Medicaid Population With a Focus on “High Exposure” Patients, 2007–2012

Abstract

purpose We examined trends in utilization of computed tomography (CT) among Medicaid enrollees in North Carolina, the clinical setting in which those CT scans were performed, and the number of enrollees known to have undergone 10 or more scans in a given year. methods North Carolina Medicaid claims were analyzed to determine the number of CT studies performed between January 1, 2007, and December 31, 2012. We assessed the number of "high exposure" patients-those who received 10 or more CT scans in a given calendar year-and divided this group into patients with a diagnosis of cancer and patients without a diagnosis of cancer. We also determined the type of site at which each CT scan was performed. conclusions Although the number of CT scans performed annually in the North Carolina Medicaid population stabilized in the late 2000s (as did CT use nationally), the percentage of high-exposure patients has continued to rise. Physicians and patients need to be further educated in order to promote radiation safety and to decrease unnecessary radiation exposure.

With “Big Data” Comes Big Responsibility

“…We used Medicaid claims data to extract patient demographic characteristics and limited clinical information for all Medicaid patients in North Carolina who had claims for 10 or more CT scans during 2010; we also collected claims data for these patients for the year following the intervention-July 1, 2011, through June 30, 2012 (fiscal year [FY] 2012). For more detailed information about the types of CT scans included in this study and an explanation of how the scans were counted, readers can refer to the article by Burke and colleagues on pages 95-101 of this issue [27].…”

“…In 2012 our analyst rewrote the query to account for most of these exceptions; however, some of the inpatient claims were still bundled in such a way that they were not accessible to queries. We found that our original count of 640 high-exposure patients (shown in Figure 1) was too low; when we reran our query, we found that 2,646 Medicaid patients without a cancer diagnosis had 10 or more CT scans in 2010 [27]. All CT scan counts presented in …”

“…We used Medicaid claims data to extract patient demographic characteristics and limited clinical information for all Medicaid patients in North Carolina who had claims for 10 or more CT scans during 2010; we also collected claims data for these patients for the year following the intervention-July 1, 2011, through June 30, 2012 (fiscal year [FY] 2012). For more detailed information about the types of CT scans included in this study and an explanation of how the scans were counted, readers can refer to the article by Burke and colleagues on pages 95-101 of this issue [27].Data were collected 3 months after the end of each measurement period (on April 1, 2011, and on October 1, 2012) to allow time for Medicaid claims to be filed and processed. Since patients gain and lose Medicaid coverage throughout the year, each month's enrollment information (obtained from the DMA Web site [28]) had to be included in our analyses.…”

Cumulative doses analysis in young trauma patients: a single-centre experience

“…The widely diffused use of MDCT for different clinical purpose, however, increases patient and population radiation exposures [2]. Different concerns are consequently emerging about appropriateness, resource utilisation and possible biological costs in terms of radiation exposure.…”