Population-Based study of Echocardiography: Time Trends in Utilization and Diagonistic Profile of an Evolving Technology, 1975–1987

Ballard, David J.; Khandheria, Bijoy K.; Tajik, Ali; Seward, James B.; Weber, Vernon P.; Melton, L. Joseph

doi:10.1017/s0266462300006462

Cited by 18 publications

(4 citation statements)

References 20 publications

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“…For example, a recent study of echocardiography in the Olmsted County population revealed that use of the procedure had increased from 552/100,000 population in 1979 to 1,435/100,000 population in 1985. 30 Nonetheless, the incidence rates presented here may still be underestimates of the true rates, even for the later time period. With more thorough and definitive evaluation of cardiac symptoms and early detection of mild and asymptomatic cases, we may expect further increases in the reported incidence and prevalence of DCM and HCM.…”

Section: Resultsmentioning

confidence: 69%

Epidemiology of idiopathic dilated and hypertrophic cardiomyopathy. A population-based study in Olmsted County, Minnesota, 1975-1984.

et al. 1989

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Using the records linkage system of the Mayo Clinic and of the Rochester Epidemiology Project, which accesses diagnostic data on the entire population of Olmsted County, Minnesota, we identified 45 new cases of idiopathic dilated cardiomyopathy (DCM) and 19 new cases of hypertrophic cardiomyopathy (HCM) among county residents for the years 1975-1984. Overall age- and sex-adjusted incidence rates were 6.0/100,000 and 2.5/100,000 person-years, respectively. The incidence of DCM doubled from 3.9/100,000 in the first 5 years to 7.9/100,000 person-years in the last 5 years of study. The corresponding change for HCM was from 1.4 to 3.6/100,000 person-years. Age- and sex-adjusted prevalence rates as of January 1, 1985, for DCM and HCM were 36.5/100,000 and 19.7/100,000 population, respectively. The prevalence of DCM in persons less than 55 years old was 17.9/100,000, over a third of whom were New York Heart Association functional Class III or IV at diagnosis. These estimates may be of value in determining the potential use of health care resources, particularly cardiac transplantation.

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Section: Resultsmentioning

confidence: 69%

Epidemiology of idiopathic dilated and hypertrophic cardiomyopathy. A population-based study in Olmsted County, Minnesota, 1975-1984.

et al. 1989

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“…Approximately 1 in 50 residents of Olmsted County, Minnesota, underwent echocardiography each year for differential diagnostic assessment of cardiovascularrelated conditions during the period of this study. 24 Verification of residence was based on information obtained from city and county directories or earlier medical records. Patients were included only if their residence was established in Olmsted County, Minnesota, at least 1 year before their first echocardiographic diagnosis of valve disease.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Cerebrovascular Events and Death Among Patients With Valvular Heart Disease

Petty¹,

Khandheria²,

Whisnant³

et al. 2000

Stroke

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Background and Purpose-There is little population-based information on cerebrovascular events and survival among valvular heart disease patients. We used the Kaplan-Meier product-limit method and the Cox proportional hazards model to determine rates and predictors of cerebrovascular events and death among valve disease patients. Methods-This population-based historical cohort study in Olmsted County, Minnesota, reviewed residents with a first echocardiographic diagnosis of mitral stenosis (nϭ19), mitral regurgitation (nϭ528), aortic stenosis (nϭ140), and aortic regurgitation (nϭ106) between 1985 and 1992. Results-During 2694 person-years of follow-up, 98 patients developed cerebrovascular events and 356 died. Compared with expected numbers, these observations are significantly elevated, with standardized morbidity ratio of 3.2 (95% CI, 2.6 to 3.8) and 2.5 (95% CI, 2.2 to 2.7), respectively. Independent predictors of cerebrovascular events were age, atrial fibrillation, and severe aortic stenosis. The risk ratio of severe aortic stenosis was 3.5 (95% CI, 1.4 to 8.6), with atrial fibrillation conferring greater risk at younger age. Predictors of death were age, sex, cerebrovascular events, ischemic heart disease, and congestive heart failure, the greatest risk being among those with both congestive heart failure and cerebrovascular events (risk ratioϭ8.8; 95% CI, 5.8 to 13.4). Valve disease type and severity were not independent determinants of death. Conclusions-The risk of cerebrovascular events and death among patients with valve disease remains high. Age, atrial fibrillation, and severe aortic stenosis are independent predictors of cerebrovascular events, and age, sex, cerebrovascular events, congestive heart failure, and ischemic heart disease are independent predictors of death in these patients.

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“…Our study found a more modest growth in echocardiography utilization rates (3.9% growth over 8 years) compared with studies examining utilization of echocardiography in the private sector. 7,8,19,20 In a population-based study examining trends in the utilization of echocardiography between 1975 and 1987 among residents of Olmsted County in Minnesota, Ballard et al 19 noted a 600% increase in utilization over a 12-year period. Another study examining the use of echocardiography among Medicare beneficiaries reported a 7.7% annual growth in the volume of echocardiography services between 1999 and 2004 after accounting for growth in the Medicare population.…”

Section: Discussionmentioning

confidence: 99%

Trends in echocardiography utilization in the Veterans Administration Healthcare System

Okrah¹,

Vaughan-Sarrazin²,

Cram³

2010

American Heart Journal

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Background There is growing concern over the impact of accelerating use of diagnostic imaging services on health care spending. Echocardiography is an important cardiovascular imaging procedure, but little is known about trends in its use or utilization. We examine trends in the utilization of echocardiography in a national health care system. Methods We used administrative data from the Veterans Healthcare Administration (VA) from 2000 to 2007 to identify patients receiving regular medical care (VA users) or echocardiograms at the VA. We then examined the number of echocardiograms performed each year within the VA and echocardiogram utilization (rates per 1,000 VA users). We examined changes in echocardiogram use and utilization over time and potential overuse of echocardiography. Results The number of echocardiograms increased from 92,269 in 2000 to 195,767 in 2007 (a 112.2% increase). Alternatively, echocardiogram utilization remained relatively stable, increasing from 68.8 per 1,000 VA users in 2000 to 71.5 per 1,000 VA users in 2007 because the number of VA users increased by 104.2% over the study period. The mean number of scans per year in echocardiogram recipients remained constant at 1.1/y, and the proportion of recipients receiving multiple scans remained constant at <10%. Conclusions Use of echocardiography in the VA increased dramatically between 2000 and 2007, but utilization rates increased only modestly. Our results suggest that, within the VA, growth in the use of echocardiography resulted from an increase in the number of patients receiving care from the VA on regular basis rather than the performance of a greater number of echocardiograms on a fixed patient population.

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Population-Based study of Echocardiography: Time Trends in Utilization and Diagonistic Profile of an Evolving Technology, 1975–1987

Cited by 18 publications

References 20 publications

Epidemiology of idiopathic dilated and hypertrophic cardiomyopathy. A population-based study in Olmsted County, Minnesota, 1975-1984.

Epidemiology of idiopathic dilated and hypertrophic cardiomyopathy. A population-based study in Olmsted County, Minnesota, 1975-1984.

Predictors of Cerebrovascular Events and Death Among Patients With Valvular Heart Disease

Trends in echocardiography utilization in the Veterans Administration Healthcare System

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