{"id":"https://openalex.org/W2099388335","doi":"https://doi.org/10.2214/ajr.10.5823","title":"The Effect of Self-Referral on Utilization of Advanced Diagnostic Imaging","display_name":"The Effect of Self-Referral on Utilization of Advanced Diagnostic Imaging","publication_year":2011,"publication_date":"2011-03-22","ids":{"openalex":"https://openalex.org/W2099388335","doi":"https://doi.org/10.2214/ajr.10.5823","mag":"2099388335","pmid":"https://pubmed.ncbi.nlm.nih.gov/21427334"},"language":"en","primary_location":{"id":"doi:10.2214/ajr.10.5823","doi":"https://doi.org/10.2214/ajr.10.5823","is_oa":false,"landing_page_url":"https://doi.org/10.2214/ajr.10.5823","pdf_url":null,"source":{"id":"https://openalex.org/S161085503","display_name":"American Journal of Roentgenology","issn_l":"0002-9580","issn":["0002-9580","0361-803X","1546-3141"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","ki-jl-2","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315781","host_organization_name":"American Roentgen Ray Society","host_organization_lineage":["https://openalex.org/P4310315781"],"host_organization_lineage_names":["American Roentgen Ray Society"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Roentgenology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5019016626","display_name":"David C. Levin","orcid":"https://orcid.org/0000-0002-9927-7311","observed_orcids":["https://orcid.org/0000-0002-9927-7311"]},"institutions":[{"id":"https://openalex.org/I149251103","display_name":"Thomas Jefferson University","ror":"https://ror.org/00ysqcn41","country_code":"US","type":"education","lineage":["https://openalex.org/I149251103"]},{"id":"https://openalex.org/I2799360765","display_name":"Thomas Jefferson University Hospital","ror":"https://ror.org/04zhhva53","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799360765","https://openalex.org/I4210114575"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"David C. Levin","raw_affiliation_strings":["Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Main 1090, 132 S 10th St, Philadelphia, PA 19107","HealthHelp, Houston, TX","Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Main 1090, 132 S 10th St, Philadelphia, PA 19107, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Main 1090, 132 S 10th St, Philadelphia, PA 19107","institution_ids":["https://openalex.org/I149251103","https://openalex.org/I2799360765"]},{"raw_affiliation_string":"HealthHelp, Houston, TX","institution_ids":[]},{"raw_affiliation_string":"Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Main 1090, 132 S 10th St, Philadelphia, PA 19107, USA","institution_ids":["https://openalex.org/I149251103","https://openalex.org/I2799360765"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5042081481","display_name":"Vijay M. Rao","orcid":"https://orcid.org/0000-0002-7174-3608","observed_orcids":["https://orcid.org/0000-0002-7174-3608"]},"institutions":[{"id":"https://openalex.org/I149251103","display_name":"Thomas Jefferson University","ror":"https://ror.org/00ysqcn41","country_code":"US","type":"education","lineage":["https://openalex.org/I149251103"]},{"id":"https://openalex.org/I2799360765","display_name":"Thomas Jefferson University Hospital","ror":"https://ror.org/04zhhva53","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799360765","https://openalex.org/I4210114575"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Vijay M. Rao","raw_affiliation_strings":["Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Main 1090, 132 S 10th St, Philadelphia, PA 19107"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Main 1090, 132 S 10th St, Philadelphia, PA 19107","institution_ids":["https://openalex.org/I149251103","https://openalex.org/I2799360765"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":12.039,"has_fulltext":false,"cited_by_count":49,"citation_normalized_percentile":{"value":0.98160928,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":99},"biblio":{"volume":"196","issue":"4","first_page":"848","last_page":"852"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.5756999850273132,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.5756999850273132,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.38449999690055847,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11894","display_name":"Radiology practices and education","score":0.015399999916553497,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/self-referral","display_name":"self-referral","score":0.9890000224113464},{"id":"https://openalex.org/keywords/medical-imaging-utilization","display_name":"imaging utilization","score":0.746999979019165},{"id":"https://openalex.org/keywords/health-care-costs","display_name":"health care costs","score":0.6499999761581421},{"id":"https://openalex.org/keywords/stark-law","display_name":"Stark Law","score":0.753000020980835},{"id":"https://openalex.org/keywords/physician-self-interest","display_name":"physician self-interest","score":0.7009999752044678}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9763463735580444},{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.6321588754653931},{"id":"https://openalex.org/C19527891","wikidata":"https://www.wikidata.org/wiki/Q1120908","display_name":"Medical physics","level":1,"score":0.5362263321876526},{"id":"https://openalex.org/C31601959","wikidata":"https://www.wikidata.org/wiki/Q931309","display_name":"Medical imaging","level":2,"score":0.5154343843460083},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3323485255241394},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.30961722135543823}],"mesh":[{"descriptor_ui":"D003952","descriptor_name":"Diagnostic Imaging","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008402","descriptor_name":"Mass Media","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011639","descriptor_name":"Public Opinion","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014487","descriptor_name":"Centers for Medicare and Medicaid Services, U.S.","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018584","descriptor_name":"Physician Self-Referral","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.2214/ajr.10.5823","doi":"https://doi.org/10.2214/ajr.10.5823","is_oa":false,"landing_page_url":"https://doi.org/10.2214/ajr.10.5823","pdf_url":null,"source":{"id":"https://openalex.org/S161085503","display_name":"American Journal of Roentgenology","issn_l":"0002-9580","issn":["0002-9580","0361-803X","1546-3141"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","ki-jl-2","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315781","host_organization_name":"American Roentgen Ray Society","host_organization_lineage":["https://openalex.org/P4310315781"],"host_organization_lineage_names":["American Roentgen Ray Society"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Roentgenology","raw_type":"journal-article"},{"id":"pmid:21427334","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/21427334","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"AJR. American journal of roentgenology","raw_type":"Journal Article"},{"id":"pmh:oai:repository.library.georgetown.edu:10822/1017929","doi":null,"is_oa":false,"landing_page_url":"http://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=The+effect+of+self-referral+on+utilization+of+advanced+diagnostic+imaging.&title=AJR.+American+journal+of+roentgenology+&volume=196&issue=4&date=2011-04&au=Levin,+David+C;+Rao,+Vijay+M","pdf_url":null,"source":{"id":"https://openalex.org/S4306402467","display_name":"DigitalGeorgetown (Georgetown University Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I4210145449","host_organization_name":"Center for Security and Emerging Technology","host_organization_lineage":["https://openalex.org/I4210145449"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"eweb:338297","raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.5683000087738037}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":39,"referenced_works":["https://openalex.org/W1964540598","https://openalex.org/W1968098708","https://openalex.org/W1969352814","https://openalex.org/W1970424280","https://openalex.org/W1977254287","https://openalex.org/W1977383602","https://openalex.org/W1982902550","https://openalex.org/W1985105256","https://openalex.org/W1998807176","https://openalex.org/W2002470324","https://openalex.org/W2019657191","https://openalex.org/W2019714585","https://openalex.org/W2020075522","https://openalex.org/W2030826506","https://openalex.org/W2036458822","https://openalex.org/W2038541541","https://openalex.org/W2042148076","https://openalex.org/W2048131503","https://openalex.org/W2063162301","https://openalex.org/W2066451713","https://openalex.org/W2069435307","https://openalex.org/W2083033129","https://openalex.org/W2097879353","https://openalex.org/W2099765281","https://openalex.org/W2106405194","https://openalex.org/W2119660200","https://openalex.org/W2121337530","https://openalex.org/W2126492003","https://openalex.org/W2133619004","https://openalex.org/W2138287683","https://openalex.org/W2140259241","https://openalex.org/W2144520596","https://openalex.org/W2145438415","https://openalex.org/W2170443743","https://openalex.org/W2172017118","https://openalex.org/W2413173610","https://openalex.org/W3209374444","https://openalex.org/W4285719527","https://openalex.org/W4298052111"],"related_works":["https://openalex.org/W2125328502","https://openalex.org/W2099765281","https://openalex.org/W2013704628","https://openalex.org/W2091396443","https://openalex.org/W1976095323","https://openalex.org/W2953520922","https://openalex.org/W2959864002","https://openalex.org/W2105040305","https://openalex.org/W2999127182","https://openalex.org/W2940133678"],"abstract_inverted_index":{"OBJECTIVE:":[0],"This":[1],"article":[2],"reviews":[3],"the":[4,7,30,52,58,67,73],"evidence":[5,20],"on":[6],"relationship":[8],"between":[9],"recent":[10],"increases":[11],"in":[12],"utilization":[13,28],"of":[14,54],"diagnostic":[15],"imaging":[16,42],"and":[17,29,57,62],"self-referral.":[18,55],"The":[19],"shows":[21],"that":[22],"self-referral":[23],"invariably":[24],"leads":[25],"to":[26,72,79],"higher":[27,32],"attendant":[31],"costs.":[33],"CONCLUSION:":[34],"Because":[35],"most":[36],"physicians":[37],"do":[38],"not":[39],"own":[40,45],"advanced":[41,80],"equipment,":[43],"their":[44],"best":[46],"interests":[47],"are":[48],"being":[49],"thwarted":[50],"by":[51],"practice":[53],"Congress":[56],"Centers":[59],"for":[60],"Medicare":[61],"Medicaid":[63],"Services":[64],"should":[65],"restrict":[66],"in-office":[68],"ancillary":[69],"services":[70],"exception":[71],"Stark":[74],"laws":[75],"as":[76],"it":[77],"applies":[78],"imaging.":[81]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":1},{"year":2023,"cited_by_count":4},{"year":2021,"cited_by_count":3},{"year":2020,"cited_by_count":2},{"year":2019,"cited_by_count":3},{"year":2018,"cited_by_count":3},{"year":2017,"cited_by_count":2},{"year":2016,"cited_by_count":6},{"year":2015,"cited_by_count":7},{"year":2014,"cited_by_count":3},{"year":2013,"cited_by_count":7},{"year":2012,"cited_by_count":5}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}