Estimated growth of lung volume reduction surgery among Medicare enrollees: 1994 to 1996.
OBJECTIVE
To estimate the number of lung volume reduction surgery procedures performed on Medicare enrollees from 1994 to 1996.


METHODS
Statistical analysis of national Medicare claims data.


METHODS
All Medicare enrollees with emphysema hating claims records for pulmonary resection procedures from January 1, 1993, through December 31, 1996.


METHODS
Estimated number of lung volume reduction procedures performed per month from July 1994 through December 1996.


RESULTS
An estimated 1,212 lung volume reduction procedures were performed on Medicare enrollees between July 1994 and December 1995 (95% confidence interval, 1,012 to 1,408). Nearly one half of these procedures were performed in the last 3 months of 1995. At the time Health Care Financing Administration announced that it would suspend reimbursement for the procedure (December 1995), lung volume reduction surgery was being performed in 37 states. The number of claims per month decreased from a peak of 169 in December 1995, to 11 in March 1996. Average Medicare reimbursement per procedure was $31,398.


CONCLUSIONS
Lung volume reduction surgery for patients increased rapidly following its reintroduction in 1994. The growth of lung volume reduction surgery demonstrates that widespread adoption and utilization of a surgical procedure can occur in the absence of data from controlled clinical trials. Medicare expenditures for lung volume reduction surgery were an estimated $30 million to $50 million. Performing the surgery for all current Medicare patients who meet the appropriate clinical criteria would cost an estimated $1 billion.
Huizenga
H F
HF
Division of General Internal Medicine and Health Services, University of Washington, Veterans Administration Puget Sound Health Care System, Seattle 98108, USA. huhuiz@u.washington.edu
Ramsey
S D
SD
Albert
R K
RK
D019538:Health Care Surveys; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data*; D011013:Pneumonectomy / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States; D014600:Utilization Review