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National trends in venous disease.
Geoffrey D Barnes1, Sameer Gafoor, Thomas Wakefield
1Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Mich, USA. gbarnes@umich.edu
Journal of Vascular Surgery
|March 23, 2010
Summary
Over 46 million outpatient and emergency visits for venous disease occurred nationally from 1997-2006. Many deep vein thrombosis (DVT) patients seen by primary care providers (PCPs) may need more ultrasound training.
Area of Science:
- Vascular Medicine
- Medical Informatics
- Public Health
Background:
- The national burden of venous disease and ultrasound (US) utilization in outpatient and emergency departments (EDs) is not well-defined.
- Venous diseases, including phlebitis, represent a significant healthcare concern.
- Understanding diagnostic trends and provider patterns is crucial for effective patient management.
Purpose of the Study:
- To quantify the national prevalence of venous disease visits in outpatient and ED settings.
- To characterize the diagnostic use of ultrasound for venous conditions.
- To analyze patient visit characteristics and provider patterns for venous disease.
Main Methods:
- Analysis of 1997-2006 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) data.
- Utilized ICD-9 coding for diagnoses of venous disease and phlebitis.
- Employed logistic regression and odds ratios to examine patient and visit characteristics, including ultrasound use.
Main Results:
- Over 46 million visits for venous disease occurred nationally (average 4.6 million/year), with an increasing trend.
- Deep vein thrombosis (DVT) accounted for approximately 236,000 ED visits annually, showing a slight increase.
- Primary care providers (PCPs) managed a significant number of venous disease and DVT cases, with specialists more likely to see non-DVT venous disease.
Conclusions:
- Venous disease, including DVT, is a growing concern in outpatient settings, managed by both PCPs and specialists.
- Despite outpatient management, there was no significant shift away from ED care for DVT over the study period.
- A notable proportion of DVT patients did not receive ultrasounds during their visit, suggesting a need for enhanced PCP training and resources.
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