Impact of insurance carrier, prior authorization, and socioeconomic status on appropriate use of SPECT myocardial perfusion imaging in private community-based office practice.

ABSTRACT:

Background

The impact of health insurance carrier and socioeconomic status (SES) on the adherence to appropriate use criteria (AUC) for radionuclide myocardial perfusion imaging (MPI) is unknown.

Hypothesis

Health insurance carrier's prior authorization and patient's SES impact adherence to AUC for MPI in a fee-for-service setting.

Methods

We conducted a prospective cohort study of 1511 consecutive patients who underwent outpatient MPI in a multi-site, office-based, fee-for-service setting. The patients were stratified according to the 2009 AUC into appropriate/uncertain appropriateness and inappropriate use groups. Insurance status was categorized as Medicare (does not require prior authorization) vs commercial (requires prior authorization). Socioeconomic status was

SUBMITTER: Doukky R 

PROVIDER: S-EPMC6711012 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature