Radiologists are performing paracentesis and thoracentesis procedures on Medicare beneficiaries more frequently than in the past, according to new research published in the Journal of Vascular and Interventional Radiology.
These procedures were once commonly performed by nonradiologist physicians at bedside, the study’s authors explained, but radiologists started doing them more and more as image guidance became a central part of the process.
The Harvey L. Neiman Health Policy Institute study explored Medicare claims data from 2004 to 2016. Overall, the researchers found, the proportion of paracentesis procedures handled by radiologists jumped from 70% to 80%. Thoracentesis procedures performed by radiologists increased from 47% to 66%.
“For both paracentesis and thoracentesis procedures, we observed an increase over time in the proportion of procedures performed by radiologists compared to non-radiologists,” first author Ravi V. Gottumukkala, MD, a radiology fellow at Massachusetts General Hospital in Boston, said in a prepared statement. “Additionally, while for both procedures, radiologists increasingly perform the majority of services on both weekdays and weekends, we found that the proportion of the services provided by radiologists was greater on weekdays compared to weekends.”
Also, as far as patient complexity is concerned, no considerable difference between the procedures performed by radiologists and nonradiologists was detected. Prior studies had indicated that radiologists are often tasked with handling more complex patients than nonradiologist colleagues, but these findings don’t show such a trend when it comes to these two image-guided procedures.
“In aggregate, the present findings suggest that previous implications from analyses of diagnostic imaging services, including the possibility of selective referral to radiologists of imaging studies performed off-hours and on more complex patients, do not apply to at least this subset of image-guided procedures,” the authors concluded. “Further study is warranted to determine what factors govern referral choices across the spectrum of image-guided procedures; how such choices impact cost, quality, and accessibility of care; and how best to incorporate these data into referral guidelines and emerging quality-based payment programs.”