Measuring the performance of screening mammography in community practice with Medicare claims data. Women Health 2003;37(2):1-15
Date
05/08/2003Pubmed ID
12733550DOI
10.1300/J013v37n02_01Scopus ID
2-s2.0-0037765033 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
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.
Author List
Freeman JL, Goodwin JS, Zhang D, Nattinger AB, Freeman DH JrAuthor
Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedBreast Neoplasms
Community Health Services
Continuity of Patient Care
False Positive Reactions
Female
Health Services Research
Humans
Insurance Claim Review
Mammography
Medicare
Quality of Health Care
SEER Program
Sensitivity and Specificity