Nationwide Utilization of Computerized Dynamic Posturography in an Era of Deimplementation

Douglas J. Chieffe, Steven A. Zuniga, Schelomo Marmor, Meredith E. Adams

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Computerized dynamic posturography (CDP) provides multisensory assessment of balance. Consensus is lacking regarding CDP utility and coverage determinations vary. To inform best practices and policy, this cross-sectional study quantifies provider use of CDP among Medicare beneficiaries over time (2012-2017), by geographic region (hospital referral region [HRR]), and specialty. We observed 195,267 beneficiaries underwent 212,847 CDP tests totaling $15,780,001 in payments. Number of CDPs billed per 100,000 beneficiaries varied 534-fold across HRRs. Over 6 years, CDP use grew by 84% despite stagnant reimbursement. More utilization was attributable to primary care clinicians than specialties focused on care for dizziness and balance disorders. The observed growth and variation illustrate the potential for policy and provider preferences to drive unexpected practice patterns and underscore the need to engage a broad network of providers to develop optimal guidelines for use. CDP may offer a use case for deimplementation of low-value diagnostic services.

Original languageEnglish (US)
Pages (from-to)1090-1093
Number of pages4
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume169
Issue number4
DOIs
StatePublished - Oct 2023

Bibliographical note

Funding Information:
This work was funded by NIH, NIDCD R21DC016359.

Publisher Copyright:
© 2023 The Authors. Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology-Head and Neck Surgery Foundation.

Keywords

  • computerized dynamic posturography
  • fall risk
  • health policy
  • health services
  • vestibular test

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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