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Bone Density Screening Rates Among Medicare Beneficiaries: An Analysis with a focus on Asian Americans

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Abstract

Purpose

To report osteoporosis screening utilization rates among Asian American (AsA) populations in the USA.

Methods

We retrospectively assessed the use of dual-energy X-ray absorptiometry (DXA) screening using the Medicare 5% Research Identifiable Files. Using Current Procedural Terminology (CPT) codes indicative of a DXA scan, we identified patients recommended for DXA screening according to the ACR-SPR-SSR Practice Parameters (females ≥ 65 years, males ≥ 70 years). Sociodemographic factors and their association with screening were evaluated using chi-square tests.

Results

There were 80,439 eligible AsA beneficiaries, and 12,102 (15.1%) received osteoporosis screening. DXA rate for women was approximately four times greater than the rate for men (19.8% vs. 5.0%; p < 0.001). AsA beneficiaries in zip codes with higher mean household income (MHI) were more likely to have DXA than those in lower MHI areas (17.6% vs. 14.3%, p < 0.001). AsA beneficiaries aged < 80 were more likely to receive DXA (15.5%) than those aged ≥ 80 (14.1%, p < 0.001). There were 2,979,801 eligible non-AsA beneficiaries, and 496,957 (16.7%) received osteoporosis screening during the study period. Non-Hispanic white beneficiaries had the highest overall screening rate (17.5%), followed by North American Native (13.0%), Black (11.8%), and Hispanic (11.1%) beneficiaries. Comparing AsA to non-AsA populations, there were significantly lower DXA rates among AsA beneficiaries when controlling for years of Medicare eligibility, patient age, sex, location, and mean income (p < 0.001).

Conclusion

We found lower than expected DXA screening rates for AsA patients. A better understanding of the barriers and facilitators to AsA osteoporosis screening is needed to improve patient care.

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Funding

This project was funded by the Radiological Society of North America Emerging Issues Grant (Gyftopoulos, Pelzl, Kwon, and Chang) and the Massachusetts General Hospital Schlaeger Fellowship (Chang).

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Authors and Affiliations

  1. Department of Radiology, NYU Langone Health, New York, NY, USA

    Soterios Gyftopoulos & Madalena Da Silva Cardoso

  2. Harvey L. Neiman Health Policy Institute, American College of Radiology, Reston, VA, USA

    Casey E. Pelzl

  3. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA

    Juliana Xie & Connie Y. Chang

  4. Department of Population Health, NYU Langone Health, New York, NY, USA

    Simona C. Kwon

  5. Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA

    Soterios Gyftopoulos

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  1. Soterios Gyftopoulos
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  2. Casey E. Pelzl
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Correspondence to Soterios Gyftopoulos.

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Gyftopoulos, S., Pelzl, C.E., Da Silva Cardoso, M. et al. Bone Density Screening Rates Among Medicare Beneficiaries: An Analysis with a focus on Asian Americans. Skeletal Radiol (2024). https://doi.org/10.1007/s00256-024-04643-1

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  • DOI: https://doi.org/10.1007/s00256-024-04643-1

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