2005 to 2023 saw decrease in dual-energy X-ray absorptiometry testing for osteoporosis screening

From 2005 to 2023, dual-energy X-ray absorptiometry (DXA) testing for osteoporosis among Medicare beneficiaries saw a significant decrease, according to a study published in Osteoporosis International. The research, led by Casey E. Pelzl and colleagues, analyzed data from 5,243,098 unique beneficiaries over a 19-year period, finding that the overall annual DXA utilization rate dropped by 35.4%, from 7,255 tests to 4,690 tests per 100,000 beneficiaries.

This decline was most pronounced in the Hispanic population, with a 35.3% decrease in DXA utilization. Moreover, beneficiaries with a Neiman Imaging Comorbidity Index of 7 or higher experienced a 57.7% increase in the adjusted odds of undergoing DXA testing. The study underscores the disconnect between clinical need and access to osteoporosis screening, particularly for populations already facing barriers to care, which can have serious implications for fracture prevention, health equity, and long-term Medicare expenditures.