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Utilization of Surveillance after Polypectomy in the Medicare Population – A Cohort Study

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  • Iris Lansdorp-Vogelaar
  • Stacey Fedewa
  • Chun Chieh Lin
  • Katherine S Virgo
  • Ahmedin Jemal

Abstract

Background: Surveillance in patients with previous polypectomy was underused in the Medicare population in 1994. This study investigates whether expansion of Medicare reimbursement for colonoscopy screening in high-risk individuals has reduced the inappropriate use of surveillance. Methods: We used Kaplan-Meier analysis to estimate time to surveillance and polyp recurrence rates for Medicare beneficiaries with a colonoscopy with polypectomy between 1998 and 2003 who were followed through 2008 for receipt of surveillance colonoscopy. Generalized Estimating Equations were used to estimate risk factors for: 1) failing to undergo surveillance and 2) polyp recurrence among these individuals. Analyses were stratified into three 2-year cohorts based on baseline colonoscopy date. Results: Medicare beneficiaries undergoing a colonoscopy with polypectomy in the 1998–1999 (n = 4,136), 2000–2001 (n = 3,538) and 2002–2003 (n = 4,655) cohorts had respective probabilities of 30%, 26% and 20% (p

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  • Iris Lansdorp-Vogelaar & Stacey Fedewa & Chun Chieh Lin & Katherine S Virgo & Ahmedin Jemal, 2014. "Utilization of Surveillance after Polypectomy in the Medicare Population – A Cohort Study," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-8, November.
    • Handle: RePEc:plo:pone00:0110937
    DOI: 10.1371/journal.pone.0110937
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