Abstract：
BACKGROUND: Clinical guidelines and scientific data increasingly support the appropriate use of cardiovascular magnetic resonance (CMR) . The extent of CMR adoption across the United States (US) remains unclear. This observational analysis aims to capture CMR practice patterns in the US.
METHODS: Commissioned reports from the Society for Cardiovascular Magnetic Resonance (SCMR), pre-existing survey data from CMR centers, and socioeconomic and coronary heart disease data from the Centers for Disease Control and Prevention were used. The location of imaging centers performing CMR was based on 2018 Medicare claims. Secondary analysis was performed on center-specific survey data from 2017-2019, which were collected by members of the SCMR US Advocacy Subcommittee for quality improvement purposes. The correlation between the number of imaging centers billing for CMR services per million persons, socioeconomic determinants, and coronary heart disease epidemiology was determined.
RESULTS: A total of 591 imaging centers billed the Center for Medicare & Medicaid Services for CMR services in 2018 and 112 (of 155) unique CMR centers responded to the survey. In 2018, CMR services were available in almost all 50 states. Minnesota was the state with the highest number of CMR centers per million Medicare beneficiaries (52.6 centers per million), and Maine had the lowest (4.4 per million). The total density of CMR centers was 16 per million for US Medicare beneficiaries. Sixty-eight percent (83 of 112) of survey responders were cardiologists, and 28% (31/112) were radiologists. In 72% (71/112) of centers, academic health care systems performed 81%-100% of CMR exams. The number of high-volume centers (>500 scans per year) increased by seven between 2017 and 2019. In 2019, 53% (59/112) of centers were considered high-volume centers and had an average of 19 years of experience. Centers performing <50 scans had on average 3.5 years of experience. Approximate patient wait time for a CMR exam was 2 weeks to 1 month.
CONCLUSIONS: Despite increasing volume and availability in almost all 50 states, CMR access remains geographically variable. Advocacy efforts to improve access and innovations that reduce imaging time and exam complexity have the potential to increase the adoption of CMR technology.
METHODS: Commissioned reports from the Society for Cardiovascular Magnetic Resonance (SCMR), pre-existing survey data from CMR centers, and socioeconomic and coronary heart disease data from the Centers for Disease Control and Prevention were used. The location of imaging centers performing CMR was based on 2018 Medicare claims. Secondary analysis was performed on center-specific survey data from 2017-2019, which were collected by members of the SCMR US Advocacy Subcommittee for quality improvement purposes. The correlation between the number of imaging centers billing for CMR services per million persons, socioeconomic determinants, and coronary heart disease epidemiology was determined.
RESULTS: A total of 591 imaging centers billed the Center for Medicare & Medicaid Services for CMR services in 2018 and 112 (of 155) unique CMR centers responded to the survey. In 2018, CMR services were available in almost all 50 states. Minnesota was the state with the highest number of CMR centers per million Medicare beneficiaries (52.6 centers per million), and Maine had the lowest (4.4 per million). The total density of CMR centers was 16 per million for US Medicare beneficiaries. Sixty-eight percent (83 of 112) of survey responders were cardiologists, and 28% (31/112) were radiologists. In 72% (71/112) of centers, academic health care systems performed 81%-100% of CMR exams. The number of high-volume centers (>500 scans per year) increased by seven between 2017 and 2019. In 2019, 53% (59/112) of centers were considered high-volume centers and had an average of 19 years of experience. Centers performing <50 scans had on average 3.5 years of experience. Approximate patient wait time for a CMR exam was 2 weeks to 1 month.
CONCLUSIONS: Despite increasing volume and availability in almost all 50 states, CMR access remains geographically variable. Advocacy efforts to improve access and innovations that reduce imaging time and exam complexity have the potential to increase the adoption of CMR technology.
摘要：
背景：临床指南和科学数据越来越支持适当使用心血管磁共振（CMR）成像。在美国（美国）采用CMR的程度尚不清楚。本观察性分析旨在捕获美国
方法：心血管磁共振学会（SCMR）委托报告，来自CMR中心的预先存在的调查数据，使用了疾病控制和预防中心的社会经济和冠心病数据。执行CMR的成像中心的位置基于2018年的Medicare索赔。对2017-2019年针对特定中心的调查数据进行了二次分析，这些数据是由SCMR美国倡导小组委员会的成员收集的，用于提高质量。每百万人CMR服务的成像中心数量之间的相关性，社会经济决定因素，并确定了冠心病流行病学。
结果：2018年共有591个影像中心向医疗保险和医疗补助服务中心收取CMR服务的费用，112个（155个）独特的CMR中心对调查做出了回应。2018年，CMR服务几乎在所有50个州都可用。明尼苏达州是每百万Medicare受益人中CMR中心数量最多的州（每百万52.6个中心），缅因州最低（百万分之4.4）。美国医疗保险受益人的CMR中心总密度为每百万16。68%(112人中有83人)的调查响应者是心脏病专家，28%是放射科医生。在72%的中心，学术医疗保健系统进行了81-100%的CMR考试。在2017年至2019年之间，高容量中心的数量（每年扫描超过500次）增加了7个。2019年，53%的中心被认为是高容量中心，平均有19年的经验。执行<50次扫描的中心平均有3.5年的经验。CMR检查的患者等待时间约为2周至1个月。
结论：尽管几乎所有50个州的数量和可用性都在增加，CMR访问在地理上仍然可变。倡导改善获取和创新以减少成像时间和检查复杂性的努力有可能增加CMR技术的采用。
方法：心血管磁共振学会（SCMR）委托报告，来自CMR中心的预先存在的调查数据，使用了疾病控制和预防中心的社会经济和冠心病数据。执行CMR的成像中心的位置基于2018年的Medicare索赔。对2017-2019年针对特定中心的调查数据进行了二次分析，这些数据是由SCMR美国倡导小组委员会的成员收集的，用于提高质量。每百万人CMR服务的成像中心数量之间的相关性，社会经济决定因素，并确定了冠心病流行病学。
结果：2018年共有591个影像中心向医疗保险和医疗补助服务中心收取CMR服务的费用，112个（155个）独特的CMR中心对调查做出了回应。2018年，CMR服务几乎在所有50个州都可用。明尼苏达州是每百万Medicare受益人中CMR中心数量最多的州（每百万52.6个中心），缅因州最低（百万分之4.4）。美国医疗保险受益人的CMR中心总密度为每百万16。68%(112人中有83人)的调查响应者是心脏病专家，28%是放射科医生。在72%的中心，学术医疗保健系统进行了81-100%的CMR考试。在2017年至2019年之间，高容量中心的数量（每年扫描超过500次）增加了7个。2019年，53%的中心被认为是高容量中心，平均有19年的经验。执行<50次扫描的中心平均有3.5年的经验。CMR检查的患者等待时间约为2周至1个月。
结论：尽管几乎所有50个州的数量和可用性都在增加，CMR访问在地理上仍然可变。倡导改善获取和创新以减少成像时间和检查复杂性的努力有可能增加CMR技术的采用。
