UNLABELLED: Using national Medicare data from 1999-2006, we evaluated the relationship between travel distance and receipt of dual-energy X-ray absorptiometry (DXA). After adjusting for potentially confounding factors, travel distance was strongly associated with DXA testing. Rural residents were most strongly dependent on the availability of DXAs performed in physician offices. INTRODUCTION: Medicare reimbursement for DXAs performed in non-facility settings (e.g., physician offices) decreased in 2007. With declining reimbursement, some DXA providers may cease providing this service, which would increase travel distance for some people. The impact of travel distance on access to DXA is unclear. METHODS: Using national Medicare data, we identified claims for DXA to evaluate trends in the number and locations of DXAs performed. Travel distance was the distance from beneficiaries' residence and the nearest DXA provider. Binomial regression evaluated the relationship between travel distance and receipt of DXA. RESULTS: In 2006, 2.9 million DXAs were performed, a 103% increase since 1999. In 2005-2006, 8.0% of persons were tested at non-facility sites versus 4.2% at facility sites. The remainder (88%) had no DXA. Persons traveling 5-9, 10-24, 25-39, and 40-54, and > or = 55 miles were less likely to receive DXA (adjusted risk ratios = 0.92, 0.79, 0.43, 0.32, and 0.26, respectively, < 5 miles referent). Rural residents were more dependent than urban residents on the availability of DXA from non-facility providers. CONCLUSION: Approximately two-thirds of DXAs in 2005-2006 were performed in non-facility settings (e.g., physician offices). Rural residents would have preferentially reduced access to DXA if there were fewer non-facility sites.
UNLABELLED: Using national Medicare data from 1999-2006, we evaluated the relationship between travel distance and receipt of dual-energy X-ray absorptiometry (DXA). After adjusting for potentially confounding factors, travel distance was strongly associated with DXA testing. Rural residents were most strongly dependent on the availability of DXAs performed in physician offices. INTRODUCTION: Medicare reimbursement for DXAs performed in non-facility settings (e.g., physician offices) decreased in 2007. With declining reimbursement, some DXA providers may cease providing this service, which would increase travel distance for some people. The impact of travel distance on access to DXA is unclear. METHODS: Using national Medicare data, we identified claims for DXA to evaluate trends in the number and locations of DXAs performed. Travel distance was the distance from beneficiaries' residence and the nearest DXA provider. Binomial regression evaluated the relationship between travel distance and receipt of DXA. RESULTS: In 2006, 2.9 million DXAs were performed, a 103% increase since 1999. In 2005-2006, 8.0% of persons were tested at non-facility sites versus 4.2% at facility sites. The remainder (88%) had no DXA. Persons traveling 5-9, 10-24, 25-39, and 40-54, and > or = 55 miles were less likely to receive DXA (adjusted risk ratios = 0.92, 0.79, 0.43, 0.32, and 0.26, respectively, < 5 miles referent). Rural residents were more dependent than urban residents on the availability of DXA from non-facility providers. CONCLUSION: Approximately two-thirds of DXAs in 2005-2006 were performed in non-facility settings (e.g., physician offices). Rural residents would have preferentially reduced access to DXA if there were fewer non-facility sites.
Authors: Russel Burge; Bess Dawson-Hughes; Daniel H Solomon; John B Wong; Alison King; Anna Tosteson Journal: J Bone Miner Res Date: 2007-03 Impact factor: 6.741
Authors: D H Solomon; J M Polinski; C Truppo; C Egan; S Jan; M Patel; T W Weiss; Y T Chen; M A Brookhart Journal: Osteoporos Int Date: 2006-07-20 Impact factor: 4.507
Authors: Lisa M Kern; Neil R Powe; Michael A Levine; Annette L Fitzpatrick; Tamara B Harris; John Robbins; Linda P Fried Journal: Ann Intern Med Date: 2005-02-01 Impact factor: 25.391
Authors: S T Harris; N B Watts; H K Genant; C D McKeever; T Hangartner; M Keller; C H Chesnut; J Brown; E F Eriksen; M S Hoseyni; D W Axelrod; P D Miller Journal: JAMA Date: 1999-10-13 Impact factor: 56.272
Authors: B Ettinger; D M Black; B H Mitlak; R K Knickerbocker; T Nickelsen; H K Genant; C Christiansen; P D Delmas; J R Zanchetta; J Stakkestad; C C Glüer; K Krueger; F J Cohen; S Eckert; K E Ensrud; L V Avioli; P Lips; S R Cummings Journal: JAMA Date: 1999-08-18 Impact factor: 56.272
Authors: D M Black; S R Cummings; D B Karpf; J A Cauley; D E Thompson; M C Nevitt; D C Bauer; H K Genant; W L Haskell; R Marcus; S M Ott; J C Torner; S A Quandt; T F Reiss; K E Ensrud Journal: Lancet Date: 1996-12-07 Impact factor: 79.321
Authors: Dennis M Black; Pierre D Delmas; Richard Eastell; Ian R Reid; Steven Boonen; Jane A Cauley; Felicia Cosman; Péter Lakatos; Ping Chung Leung; Zulema Man; Carlos Mautalen; Peter Mesenbrink; Huilin Hu; John Caminis; Karen Tong; Theresa Rosario-Jansen; Joel Krasnow; Trisha F Hue; Deborah Sellmeyer; Erik Fink Eriksen; Steven R Cummings Journal: N Engl J Med Date: 2007-05-03 Impact factor: 91.245
Authors: Jeffrey R Curtis; Andrew J Laster; David J Becker; Laura Carbone; Lisa C Gary; Meredith L Kilgore; Robert Matthews; Michael A Morrisey; Kenneth G Saag; S Bobo Tanner; Elizabeth Delzell Journal: J Clin Densitom Date: 2008-09-12 Impact factor: 2.617
Authors: Amy H Warriner; Ryan C Outman; Adrianne C Feldstein; Douglas W Roblin; Jeroan J Allison; Jeffrey R Curtis; David T Redden; Mary M Rix; Brandi E Robinson; Ana G Rosales; Monika M Safford; Kenneth G Saag Journal: Med Care Date: 2014-08 Impact factor: 2.983
Authors: Amy H Warriner; Ryan C Outman; Elizabeth Kitchin; Lang Chen; Sarah Morgan; Kenneth G Saag; Jeffrey R Curtis Journal: J Bone Miner Res Date: 2012-12 Impact factor: 6.741
Authors: Maria E Suarez-Almazor; Prashanth Peddi; Ruili Luo; Hoang T Nguyen; Linda S Elting Journal: Support Care Cancer Date: 2013-10-22 Impact factor: 3.603