Authors: Abhishek Deshpande
Publish Date: 2014/05/20
Volume: 29, Issue: 8, Pages: 1165-1165
Abstract
This study by Olchanski et al1 investigated utilization of the abdominal aortic aneurysm AAA screening benefit through the Screening Abdominal Aortic Aneurysms Very Efficiently SAAAVE Act for Medicare beneficiaries and estimated whether increasing its utilization would increase life expectancy The authors conclude that screening benefits have been underutilized 1 each year among those newly eligible and that increasing utilization to 80 of the eligible population would yield substantial gains in life expectancy They also note that expanding screening to women with smoking history also has the potential for substantial health benefitsThe reported estimates may have been confounded by two factors First the current prevalence of AAA and the incidence of AAA rupture are on the decline among men as the prevalence of smoking has decreased considerably in the past decade though the prevalence continues to rise among women2 Second the data on AAA prevalence and rupture rates and surgical outcomes in women are less robust than for men3 The authors estimate the numbers indirectly from other available studies and therefore the projected estimates may not be accurate in that populationThe results of the study are important from the preventive and policy viewpoint Why is AAA screening largely underutilized in the US More studies are needed to further explore the reasons behind the underutilization The authors cite Medicare’s requirement that screening be conducted within the limited eligibility period the out of pocket deductible and the physician reimbursement as barriers to screening Lack of physician awareness may be a larger contributor As there are currently no quality measures around AAA screening it may get lost among the myriad other recommended tests The rates of AAA screening are significantly lower than colon cancer screening among Medicare beneficiaries These missed opportunities can be corrected by raising awareness of the benefits and eventually linking it as a quality metric Lastly as is evident from this study increasing utilization may yield significant gains in life expectancy among both men and women
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