title: National trends in percutaneous cholecystostomy between 1994 and 2009: perspectives from Medicare provider claims.
abstract: OBJECTIVE
  The aim of this study was to assess national trends and regional variation in the utilization of percutaneous cholecystostomy (PC).
  
  
  METHODS
  Medicare fee-for-service claims files from 1994 to 2009 were used to identify trends in PC compared with laparoscopic and open surgical gallbladder procedures. Volume, geographic variation, provider specialty, and service site were analyzed.
  
  
  RESULTS
  Between 1994 and 2009, annual PC procedures increased by 567% (from 1,085 to 7,239). Laparoscopic cholecystectomy increased by 3% (from 203,836 to 209,650), and open procedures declined by 73% (from 119,086 to 32,222). As a percentage of all gallbladder procedures, PC increased from 0.3% to 2.9% and varied considerably among Medicare regions, ranging from 1.4% (Denver) to 5.2% (Boston). Radiologists perform most PC procedures (97%), and most are performed on hospital inpatients (92%).
  
  
  CONCLUSIONS
  Annual PC procedures on Medicare beneficiaries increased almost 6-fold in recent years, as laparoscopic cholecystectomy remained stable, and open procedures declined. The relative utilization of PC varies considerably by region across the United States.
authors: Department of Radiology, Baptist Memorial Hospital, and The University of Tennessee Health Science Center, Memphis, Tennessee, USA. rduszak@duszak.com
authors: Richard
authors: R
authors: Duszak
authors: Stephen W
authors: SW
authors: Behrman
mesh_terms: D002763:Cholecystectomy / Q000706:statistics & numerical data* / Q000639:trends*; D002764:Cholecystitis / Q000453:epidemiology / Q000601:surgery*; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data*; D010535:Laparoscopy / Q000706:statistics & numerical data* / Q000639:trends; D006278:Medicare / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014600:Utilization Review