Volume 49 | Number 5 | October 2014

Abstract List

Abiy Agiro Ph.D., Gosia Sylwestrzak M.A., Christiane Shah, Thomas Power M.D., Andrea DeVries Ph.D.


To examine the association of echocardiography utilization management () program with downstream cardiac imaging utilization.

Data Sources/Study Setting

Administrative claims data from commercial health plans in ndiana, hio, entucky, isconsin, and eorgia.

Study Design

Patients undergoing index cardiovascular imaging with no imaging in the preceding year were identified ( = 112,308). Claims‐derived cardiac risk scores were used for one‐to‐one propensity score matching of patients subject to to patients without ( = 96,906). Downstream cardiac imaging utilization for 12–24 months postindex imaging was analyzed using generalized linear models and ox proportional hazards model.

Principal Findings

Downstream cardiac imaging tests were performed for 10,630 (21.9 percent) and 12,012 (24.8 percent) patients in the and non‐ groups, respectively. At 12‐month follow‐up, adjusted utilization was 15.2 (95 percent , 7.6–22.5) tests per 1,000 initially tested patients lower in the group ( < .001). The likelihood of obtaining downstream cardiac imaging in the group was 7.0 percent lower than the non‐ group (hazard ratio: 0.930; 95 percent , 0.897–0.964,  < .001).


Downstream cardiac imaging is relatively common among commercially insured patients. Every 10 initial diagnostic tests yielded two downstream imaging tests in first 24 months. program was associated with lower volumes of downstream imaging.