Cardiology Letters 2022, 31(5):276-283

Time trends in cardiac stress testing and imaging in Slovakia during the years 2011-2021. Part I.

Dúbrava J

Oddelenie neinvazívnej kardiológie, Univerzitná nemocnica Bratislava, Slovenská republika

Objectives: To analyze time trends in ordering cardiac stress testing and imaging in Slovakia, based on reported charges to health insurance companies.

Methods: We evaluated the number of procedures and payments for exercise ECG, stress echocardiography (SE), stress myocardial perfusion scintigraphy, CT angiography, and cardiac CT in Slovakia during the years 2011-2021. The data were provided by all health insurance companies in Slovakia. The number of procedures was evaluated according to the medical codes in the current "List of medical procedures and their point values".

Results: During the years 2011-2021, all health insurance companies reported that the number of CT angiographies and cardiac CT scans increased every year. The total number of heart CT increased by 510 % and payments for them increased by 296 %. The ratio of payments of health insurance companies for CT and all other analyzed tests increased from a value of 1.1 in 2011 to a value of 5.2 in 2021. Since 2017, there has been a continuous decrease in the number of exercise ECG, with a reduction of 56 % (the year 2021 vs the maximal number in the year 2012). Since 2014, the number of myocardial perfusion scintigraphies has continuously increased, while the relative frequency compared to exercise ECG also increased. The frequency of SE has permanently been very low. During the pandemic period of COVID-19 in 2020-2021, the number of performed exercise ECG and SE tests was significantly reduced, but the number of heart CT scans and myocardial perfusion scintigraphies increased significantly.

Conclusion: We present analysis of time trends in cardiac testing (exercise stress ECG, stress echocardiography, stress myocardial perfusion scintigraphy, CT coronary angiography, and coronary calcium CT) and insurance reimbursements for them in the Slovak Republic during the years 2011-2021.

Keywords: time trends; exercise ECG; myocardial perfusion scintigraphy; stress echocardiography; CT angiography; cardiac CT

Published: May 1, 2022  Show citation