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Research ArticleArticles

Computed Tomography Utilization in the North Carolina Medicaid Population With a Focus on “High Exposure” Patients, 2007–2012

Lauren M. B. Burke, Holly Biola, Linda Grey, Rita M. Lahlou, Randall M. Best and Richard C. Semelka
North Carolina Medical Journal March 2014, 75 (2) 95-101; DOI: https://doi.org/10.18043/ncm.75.2.95
Lauren M. B. Burke
assistant professor of radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • For correspondence: lauren_burke@med.unc.edu
Holly Biola
physician consultant, Community Care of North Carolina, Raleigh, North Carolina; and family physician and quality improvement physician champion, Lincoln Community Health Center, Durham, North Carolina
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Linda Grey
account manager, OptumInsight, Raleigh, North Carolina
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Rita M. Lahlou
graduate, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Randall M. Best
chief medical officer, Division of Medical Assistance, North Carolina Department of Health and Human Services, Raleigh, North Carolina; and assistant professor, Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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Richard C. Semelka
professor of radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Abstract

PURPOSE We examined trends in utilization of computed tomography (CT) among Medicaid enrollees in North Carolina, the clinical setting in which those CT scans were performed, and the number of enrollees known to have undergone 10 or more scans in a given year.

METHODS North Carolina Medicaid claims were analyzed to determine the number of CT studies performed between January 1, 2007, and December 31, 2012. We assessed the number of “high exposure” patients—those who received 10 or more CT scans in a given calendar year—and divided this group into patients with a diagnosis of cancer and patients without a diagnosis of cancer. We also determined the type of site at which each CT scan was performed.

RESULTS Over the 6-year period 2007–2012, the percentage of all enrollees who underwent any CT study ranged from 8.0% to 9.6% (126,082–177,425 enrollees). The number of CT scans performed annually increased from 2007 to 2009 and then plateaued. The number of high-exposure patients increased gradually, from 2,171 in 2007 to 4,017 in 2012. The majority of CT scans of high-exposure patients—150,241 of 251,052 (59.8%)—were performed in nonoffice outpatient settings, such as emergency departments or urgent care centers.

CONCLUSIONS Although the number of CT scans performed annually in the North Carolina Medicaid population stabilized in the late 2000s (as did CT use nationally), the percentage of high-exposure patients has continued to rise. Physicians and patients need to be further educated in order to promote radiation safety and to decrease unnecessary radiation exposure.

  • ©2014 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.
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North Carolina Medical Journal: 75 (2)
North Carolina Medical Journal
Vol. 75, Issue 2
March-April 2014
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Computed Tomography Utilization in the North Carolina Medicaid Population With a Focus on “High Exposure” Patients, 2007–2012
Lauren M. B. Burke, Holly Biola, Linda Grey, Rita M. Lahlou, Randall M. Best, Richard C. Semelka
North Carolina Medical Journal Mar 2014, 75 (2) 95-101; DOI: 10.18043/ncm.75.2.95

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Computed Tomography Utilization in the North Carolina Medicaid Population With a Focus on “High Exposure” Patients, 2007–2012
Lauren M. B. Burke, Holly Biola, Linda Grey, Rita M. Lahlou, Randall M. Best, Richard C. Semelka
North Carolina Medical Journal Mar 2014, 75 (2) 95-101; DOI: 10.18043/ncm.75.2.95
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