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Wide variation and rising utilization of stroke magnetic resonance imaging: Data from 11 States
dc.contributor.authorBurke, James F.en_US
dc.contributor.authorKerber, Kevin A.en_US
dc.contributor.authorIwashyna, Theodore J.en_US
dc.contributor.authorMorgenstern, Lewis B.en_US
dc.date.accessioned2012-03-16T15:53:33Z
dc.date.available2013-04-01T14:17:25Zen_US
dc.date.issued2012-02en_US
dc.identifier.citationBurke, James F.; Kerber, Kevin A.; Iwashyna, Theodore J.; Morgenstern, Lewis B. (2012). "Wide variation and rising utilization of stroke magnetic resonance imaging: Data from 11 States." Annals of Neurology 71(2): 179-185. <http://hdl.handle.net/2027.42/90061>en_US
dc.identifier.issn0364-5134en_US
dc.identifier.issn1531-8249en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/90061
dc.description.abstractObjective: Neuroimaging is an essential component of the acute stroke evaluation. Magnetic resonance imaging (MRI) is more accurate than computed tomography (CT) for the diagnosis of stroke, but is more costly and time‐consuming. We sought to describe changes in MRI utilization from 1999 to 2008. Methods: We performed a serial cross‐sectional study with time trends of neuroimaging in patients with a primary International Classification of Diseases, 9th Edition, Clinical Modification discharge diagnosis of stroke admitted through the emergency department in the State Inpatient Databases from 10 states. MRI utilization was measured by Healthcare Cost and Utilization Project criteria. Data were included for states from 1999 to 2008 where MRI utilization could be identified. Results: A total of 624,842 patients were hospitalized for stroke in the period of interest. MRI utilization increased in all states. Overall, MRI absolute utilization increased 38%, and relative utilization increased 235% (28% of strokes in 1999 to 66% in 2008). Over the same interval, CT utilization changed little (92% in 1999 to 95% in 2008). MRI use varied widely by state. In 2008, MRI utilization ranged from a low of 55% of strokes in Oregon to a high of 79% in Arizona. Diagnostic imaging was the fastest growing component of total hospital costs (213% increase from 1999 to 2007). Interpretation: MRI utilization during stroke hospitalization increased substantially, with wide geographic variation. Rather than replacing CT, MRI is supplementing it. Consequently, neuroimaging has been the fastest growing component of hospitalization cost in stroke. Recent neuroimaging practices in stroke are not standardized and may represent an opportunity to improve the efficiency of stroke care. Ann Neurol 2012;71:179–185en_US
dc.publisherWiley Subscription Services, Inc., A Wiley Companyen_US
dc.titleWide variation and rising utilization of stroke magnetic resonance imaging: Data from 11 Statesen_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelPsychiatryen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumRobert Wood Johnson Clinical Scholars Program, University of Michigan Medical School, 6312 Medical Science Building 1, Ann Arbor MI, 48109; Fax: (734) 647‐3301en_US
dc.contributor.affiliationumRobert Wood Johnson Clinical Scholars Program, University of Michiganen_US
dc.contributor.affiliationumStroke Program, University of Michigan Health Systemen_US
dc.contributor.affiliationumDivision of Pulmonary and Critical Care, Department of Medicine, University of Michiganen_US
dc.contributor.affiliationumDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MIen_US
dc.contributor.affiliationotherDepartment of Veterans Affairs, VA Center for Clinical Management and Research, Ann Arbor VA Healthcare Systemen_US
dc.identifier.pmid22367989en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/90061/1/22698_ftp.pdf
dc.identifier.doi10.1002/ana.22698en_US
dc.identifier.sourceAnnals of Neurologyen_US
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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