Variation in the use of echocardiography

Geographic variation in population-based rates of invasive cardiac procedures has been described. However, little is known about variation in rates of noninvasive testing for cardiovascular disease. Echocardiography is the second most common cardiac diagnostic procedure.

Population-based rates of echocardiography, adjusted for age, sex, and race, in the United States.

5% sample of Medicare Part B.

1 in 10 Medicare beneficiaries underwent echocardiography in 1995. Rates of echocardiography varied by state from 5% in Oregon to 15% in Michigan. Rates tended to be lowest in the Northern Great Plains, the Pacific Northwest, and the Rocky Mountains states. Among the 25 largest metropolitan areas, substantial variation was also apparent. For example, one fourth of Medicare beneficiaries in Miami, Florida, received echocardiography, and this proportion was more than four times greater than that seen in Seattle, Washington.

The likelihood of Medicare beneficiaries having echocardiography is influenced by where they live.