June 18, 2013
New Research on Central Venous Procedures Shows Less Reliance on Surgeons, More Involvement by Radiologists
Reston, VA – The findings of a new Harvey L. Neiman Health Policy Institute study published online today in the Journal of the American College of Radiology (JACR) confirm a major shift in practice at American hospitals regarding central venous procedures. What has traditionally been the domain of surgeons and anesthesiologists is being performed, in significantly larger numbers, by radiologists, a change that the paper’s authors say has “profound health system implications.”
The Harvey L. Neiman Health Policy Institute paper, “Central Venous Access: Evolving Roles of Radiology and other Specialties Nationally Over Two Decades,” was released today online by the JACR. The authors examined Medicare claims data from 1992 to 2011 for procedures involving central venous catheters and long-term central venous medical devices.
“This research should prompt health system leaders and administrators to re-evaluate the role of radiology departments in hospitals,” said Richard Duszak, M.D., FACR, CEO of the Neiman Institute and the paper’s lead author. “We’re seeing more radiology practices being displaced from long-standing hospital relationships because administrators think they can outsource all of their radiology needs. National data tells us, though, that radiologists are being relied upon with increasing frequency in the hospital setting to perform central venous procedures.”
The paper notes that the volume of central venous procedures among Medicare beneficiaries has grown significantly over the past two decades, with the number of long-term central venous device insertions increasing by 313 percent over that period. The researchers found that radiologists were once responsible for less than one percent of all long-term central venous devices, but now place over 48 percent of tunneled catheters and 27 percent of all medication ports. In all hospital settings combined, radiology departments are placing three of every four peripherally inserted central catheters.
“This study verifies a significant transition in the way central venous procedures are being handled in U.S. hospitals,” said Danny R. Hughes, Ph.D., one of the study’s authors. “Surgeons are stepping away from these functions and radiologists are filling the need. This tells us there is a direct tie between health policy and hospital administration decisions concerning radiology and patient access to these critical healthcare services.”
The Harvey L. Neiman Health Policy Institute (HPI) studies the value and role of radiology in evolving health care delivery and payment systems, including quality based approaches to care and the impact of medical imaging on overall health care costs. HPI research provides a foundation for evidence-based imaging policy to improve patient care and bolster efficient, effective use of health care resources.
About the Harvey L. Neiman Health Policy Institute
The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care. Visit us at www.neimanhpi.org and follow us on Twitter, LinkedIn and Facebook.