PMID- 37647820
OWN - NLM
STAT- MEDLINE
DCOM- 20230922
LR  - 20231010
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 205
DP  - 2023 Oct 15
TI  - Transcatheter Aortic Valve Replacement: Variations in Use, Charges, and Geography 
      in the United States.
PG  - 363-368
LID - S0002-9149(23)00723-3 [pii]
LID - 10.1016/j.amjcard.2023.07.151 [doi]
AB  - The use of transcatheter aortic valve replacement (TAVR) in the United States has 
      been increasing but with variability. We used a 100% sample of Medicare 
      beneficiaries (MBs), from the Centers for Medicare and Medicaid Services 
      database, who underwent TAVR by cardiologists between 2015 and 2019. We 
      stratified data by geographic region, rural/urban areas, and provider's gender. 
      We examined the average number of TAVRs performed per 100,000 MBs, the average 
      number of TAVRs performed per individual cardiologist, and the average submitted 
      charge (ASC) per procedure. The number of TAVR per 100,000 MBs was significantly 
      variable among regions in all years (all P</=0.028), except in 2015 (P=0.103), with 
      the highest rates being in the Northeast and the lowest being in the West. The 
      number of TAVRs per cardiologist was significantly different among regions only 
      in 2019 (P=0.04), with the Northeast showing the highest numbers and the South 
      showing the lowest. The ASC was also significantly variable among regions in all 
      years (all P</=0.01). The highest ASC was in the Midwest for all years, whereas the 
      lowest was in the West in 2015 to 2016 and in the South in 2017 to 2019. In all 
      years, the number of TAVRs per cardiologist was higher in urban areas than in 
      rural areas (all P<0.05); however, rural cardiologists had higher ASCs (all 
      P<0.05). The number of TAVR procedures per cardiologist was not significantly 
      different between male and female cardiologists (all P>0.1). Female cardiologists 
      had a significantly higher ASC only in 2015 (P=0.034). In conclusion, there are 
      variations in TAVR use and charges for MBs according to geographic, urban, and 
      rural regions and the performing cardiologist's gender.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Fath, Ayman R
AU  - Fath AR
AD  - Department of Cardiovascular Diseases, University of Texas Health Science Center, 
      San Antonio, Texas.
FAU - Aglan, Amro
AU  - Aglan A
AD  - Department of Internal Medicine, Beth Israel Lahey Health, Boston, Massachusetts.
FAU - Khurana, Aditya
AU  - Khurana A
AD  - Department of Radiology, Mayo Clinic, Rochester, Minnesota.
FAU - Abuasbeh, Jumanah
AU  - Abuasbeh J
AD  - Department of Public Health, University of Arizona, Phoenix, Arizona.
FAU - Eldaly, Abdullah S
AU  - Eldaly AS
AD  - Department of Surgery, Mayo Clinic, Jacksonville, Florida.
FAU - Mantha, Yogamaya
AU  - Mantha Y
AD  - Department of Cardiovascular Diseases, University of Texas Health Science Center, 
      San Antonio, Texas.
FAU - Abraham, Bishoy
AU  - Abraham B
AD  - Department of Cardiovascular Diseases, Mayo Clinic, Phoenix, Arizona.
FAU - Olagunju, Abdulbaril
AU  - Olagunju A
AD  - Department of Internal Medicine, Creighton University, Phoenix, Arizona.
FAU - Prasad, Anand
AU  - Prasad A
AD  - Department of Cardiovascular Diseases, University of Texas Health Science Center, 
      San Antonio, Texas. Electronic address: prasada@uthscsa.edu.
LA  - eng
PT  - Journal Article
DEP - 20230828
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - United States/epidemiology
MH  - Humans
MH  - Female
MH  - Male
MH  - Medicare
MH  - *Transcatheter Aortic Valve Replacement
MH  - Geography
MH  - *Cardiologists
MH  - Centers for Medicare and Medicaid Services, U.S.
OTO - NOTNLM
OT  - Cardiologist gender
OT  - Charges
OT  - Geographic distribution
OT  - Reimbursement
OT  - Rural and Urban
OT  - TAVR
OT  - Transcatheter aortic valve replacement
OT  - Variation in Utilization
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/08/31 00:41
MHDA- 2023/09/22 06:42
CRDT- 2023/08/30 18:06
PHST- 2023/05/05 00:00 [received]
PHST- 2023/07/21 00:00 [revised]
PHST- 2023/07/30 00:00 [accepted]
PHST- 2023/09/22 06:42 [medline]
PHST- 2023/08/31 00:41 [pubmed]
PHST- 2023/08/30 18:06 [entrez]
AID - S0002-9149(23)00723-3 [pii]
AID - 10.1016/j.amjcard.2023.07.151 [doi]
PST - ppublish
SO  - Am J Cardiol. 2023 Oct 15;205:363-368. doi: 10.1016/j.amjcard.2023.07.151. Epub 
      2023 Aug 28.