The geographic availability and associated utilization of dual-energy X-ray absorptiometry (DXA) testing among older persons in the United States

Curtis, J. R.; Laster, A.; Becker, D. J.; Carbone, L.; Gary, L. C.; Kilgore, M. L.; Matthews, R. S.; Morrisey, M. A.; Saag, K. G.; Tanner, S. B.; Delzell, E.

doi:10.1007/s00198-008-0821-x

Cited by 59Bone health and osteoporosis researchHealthcare Policy and ManagementHealthcare cost, quality, practices

The geographic availability and associated utilization of dual-energy X-ray absorptiometry (DXA) testing among older persons in the United States

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Curtis, J. R., Laster, A., Becker, D. J., Carbone, L., Gary, L. C., Kilgore, M. L., Matthews, R. S., Morrisey, M. A. +3 more·2009·Osteoporosis International

DOI 10.1007/s00198-008-0821-xPMC PMC2728788

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Abstract

Unlabelled Using national Medicare data from 1999-2006, we evaluated the relationship between travel distance and receipt of dual-energy X-ray absorptiometry (DXA). After adjusting for potentially confounding factors, travel distance was strongly associated with DXA testing. Rural residents were most strongly dependent on the availability of DXAs performed in physician offices.Introduction Medicare reimbursement for DXAs performed in non-facility settings (e.g., physician offices) decreased in 2007. With declining reimbursement, some DXA providers may cease providing this service, which would increase travel distance for some people. The impact of travel distance on access to DXA is unclear.Methods Using national Medicare data, we identified claims for DXA to evaluate trends in the number and locations of DXAs performed. Travel distance was the distance from beneficiaries' residence and the nearest DXA provider. Binomial regression evaluated the relationship between travel distance and receipt of DXA.Results In 2006, 2.9 million DXAs were performed, a 103% increase since 1999. In 2005-2006, 8.0% of persons were tested at non-facility sites versus 4.2% at facility sites. The remainder (88%) had no DXA. Persons traveling 5-9, 10-24, 25-39, and 40-54, and > or = 55 miles were less likely to receive DXA (adjusted risk ratios = 0.92, 0.79, 0.43, 0.32, and 0.26, respectively, < 5 miles referent). Rural residents were more dependent than urban residents on the availability of DXA from non-facility providers.Conclusion Approximately two-thirds of DXAs in 2005-2006 were performed in non-facility settings (e.g., physician offices). Rural residents would have preferentially reduced access to DXA if there were fewer non-facility sites.

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DXA is widely available even in low-resource areas, permitting evaluation of muscle mass.
“Widespread availability of DXA even in low-resource areas344 permits this evaluation.”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [344]
The Results report that 75.4% of rural Medicare beneficiaries lived within five miles of a DXA provider, supporting availability in many rural US areas. But the paper does not establish availability in low-resource areas as such; its Discussion also notes that rural access is more vulnerable to provider closures. The cited paper studies access to DXA testing, not its use to evaluate muscle mass. (LLM, conf=0.84)
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Authors: Curtis, J. R., Laster, A., Becker, D. J., Carbone, L., Gary, L. C., Kilgore, M. L., Matthews, R. S., Morrisey, M. A., Saag, K. G., Tanner, S. B., & Delzell, E.
Affiliations: University of Alabama at Birmingham (US)
University of Tennessee Health Science Center (US)
Vanderbilt University (US)
Corresponding author: Curtis, J. R.
ORCID: Laster, A.
Becker, D. J.
Carbone, L.
Gary, L. C.
Kilgore, M. L.
Morrisey, M. A.
Saag, K. G.
Tanner, S. B.
Venue: Osteoporosis International
Publisher: Springer Science and Business Media LLC
Published: 2008-12-24
Volume: 20
Issue: 9
Pages: 1553-1561
ISSN: 0937-941X (ISSN-L)
1433-2965
DOI: 10.1007/s00198-008-0821-x
PMC: PMC2728788
OpenAlex: W2054524628
Cited by: 59
References: 21
Citations by year: 2026: 5 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 6 · 2015: 3 · 2014: 3 · 2013: 4 · 2012: 4
FWCI: 3.50
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Osteoporosis International (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Amgen
Agency for Healthcare Research and Quality (U18HS016956)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR053351, K23AR053351, K24AR052361, AR-052361)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
Keywords: dual-energy X-ray absorptiometry, bone densitometry, health care access, travel distance, urban-rural differences, Medicare beneficiaries, older adults, Medicare reimbursement, osteoporosis screening
MeSH terms: Aged, Female, Medicare, Health Services Accessibility, Humans, Male, Osteoporosis, United States, Absorptiometry, Photon, Bone Density

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The geographic availability and associated utilization of dual-energy X-ray absorptiometry (DXA) testing among older persons in the United States

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