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Tytuł:
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Measuring the performance of screening mammography in community practice with Medicare claims data.
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Autorzy:
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Freeman JL; Sealy Center on Aging, Department of Preventive Medicine & Community Health, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0860, USA. />Goodwin JS
Zhang D
Nattinger AB
Freeman DH Jr
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Źródło:
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Women & health [Women Health] 2003; Vol. 37 (2), pp. 1-15.
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Typ publikacji:
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Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia : Routledge
Original Publication: Old Westbury, N. Y., Biological Sciences Program, State Univ. of New York, College at Old Westbury.
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MeSH Terms:
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Insurance Claim Review*
Medicare*
Breast Neoplasms/*diagnostic imaging
Community Health Services/*standards
Continuity of Patient Care/*standards
Mammography/*standards
Aged ; Community Health Services/statistics & numerical data ; False Positive Reactions ; Female ; Health Services Research ; Humans ; Mammography/economics ; Mammography/statistics & numerical data ; Quality of Health Care ; SEER Program ; Sensitivity and Specificity
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Grant Information:
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CA 72076 United States CA NCI NIH HHS
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Entry Date(s):
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Date Created: 20030508 Date Completed: 20030613 Latest Revision: 20181130
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Update Code:
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20240104
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DOI:
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10.1300/J013v37n02_01
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PMID:
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12733550
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Background: Few studies have examined the outcomes of screening mammography in community practice, particularly the extent of false positive exams among older asymptomatic women.
Research Design: Subjects were female Medicare beneficiaries, age 67 or older, residing in one of eleven SEER areas, with no evidence of breast cancer. Medicare claims data were used to identify their screening mammograms over two time periods, 1993-1995 and 1996-1998, and to measure their use of follow-up diagnostic testing (diagnostic mammography, breast ultrasound and breast biopsy) within three months of the screening mammogram.
Results: There were significant differences among the rates of diagnostic testing for each age group (67-74; 75+ ) by year, but no clear trend toward higher or lower rates over time. Although rates of diagnostic testing differed significantly by geographic region in both time periods 1993-1995 and 1996-1998, estimates of specificity for all regions were within AHRQ clinical practice guidelines (specificity greater than 90%). Specificity significantly improved with the volume of the radiologist's practice for the latter time period (1996-1998) but not for the former (1993-1995).
Conclusion: Medicare claims offer an accessible population-based source of data for mammography performance indicators. As such, they offer a low cost method for evaluating individual mammography practices as well as monitoring the impact of reimbursement policies, practice guidelines and laws mandating requirements for accrediting facilities.