Sex-Based Differences in Medicare Reimbursements among Ophthalmologists Persist across Time.
Sex-Based Differences in Medicare Reimbursements among Ophthalmologists Persist across Time.
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DOI：
10.1016/j.ophtha.2022.05.006
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发表时间：
2022-09
期刊：
影响因子：
13.7
通讯作者：
Zebardast, Nazlee
中科院分区：
文献类型：
--
作者：
Halawa, Omar Alaa;Sekimitsu, Sayuri;Boland, Michael, V;Zebardast, Nazlee
评估2013年至2019年期间男性和女性眼科医生之间医疗保险报销的差异。回顾性队列研究2013年至2019年期间接受医疗保险报销的眼科医生医疗保险和医疗补助服务中心医生和其他供应商公共使用文件用于确定2013年至2019年期间眼科医生提交的总报销和服务数量。报销标准化，以考虑到医疗保险每项服务报销的地域差异。来自美国社区调查（ACS）的数据被用来确定每个医生执业地点的邮政编码级社会经济特征（失业，贫困，收入和教育）。采用多变量线性回归模型评估按性别、日历年、经验年数、服务总数、ACS邮政编码数据和手术服务比例划分的年度报销差异。年度医疗保险报销、账单代码的使用（例如，在2013年至2019年期间获得医疗保险报销的20，281名眼科医生中，有15，451名（76%）是男性。提交的最常见的帐单代码是门诊和眼科检查（每年1 380万项收费）、视网膜诊断成像（每年560万项收费）、玻璃体内注射（每年290万项收费）和摘除白内障并植入透镜（每年240万项收费）。与男性相比，女性眼科医生获得的年度报销中位数较低（女性94，734.21美元，IQR 30，944.52 - 195，701.70，男性194，176.90美元，IQR 76，380.76 - 355，790.80，p<0.001），每年服务数量较少（分别为1，228，IQR 454- 2，433 vs. 2，259，IQR 996- 4，075，p<0.001）。在调整协变量后，女性眼科医生的服务费用减少了1015次（95%置信区间为1001-1029，p<0.001），获得的补偿比男性少20，209.12美元（95%置信区间为-21，717.57至18，700.66，p<0.001）。随着时间的推移，在所有类别的计费代码中，女性眼科医生的服务数量较少，从医疗保险中获得的报销也少于男性。在控制了医生和实践特征后，差异仍然存在。随着时间的推移，在大多数计费代码类别中，女性眼科医生的服务数量较少，从医疗保险中获得的报销也少于男性。在控制了医生和实践特征后，报销的差异仍然存在。
Evaluate differences in Medicare reimbursements between men and women ophthalmologists between 2013 and 2019. Retrospective cohort study Ophthalmologists between 2013 and 2019 receiving Medicare reimbursements The Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File was used to determine total reimbursements and number of services submitted by ophthalmologists between 2013 and 2019. Reimbursements were standardized to account for geographic differences in Medicare reimbursement per service. Data from the American Community Survey (ACS) were used to determine zip-code-level socioeconomic characteristics (unemployment, poverty, income, and education) for the location of each physician’s practice. A multivariable linear regression model was used to evaluate differences in annual reimbursements by gender, accounting for calendar year, years of experience, total number of services, ACS zip-code data, and proportion of procedural services. Annual Medicare reimbursement, utilization of billing codes (e.g., outpatient office visits and eye examinations, diagnostic testing, laser and surgery) Among 20,281 ophthalmologists who received Medicare reimbursements between 2013 and 2019, 15,451 (76%) were men. The most common billing codes submitted were for outpatient visits and eye examinations (13.8 million charges/year), diagnostic imaging of the retina (5.6 million charges/year), intravitreal injections (2.9 million charges/year) and removal of cataract with insertion of lens (2.4 million charges/year). Compared to men, women ophthalmologists received lower median annual reimbursements ($94,734.21, IQR 30,944.52–195,701.70 for women vs. $194,176.90, IQR 76,380.76–355,790.80 for men, p<0.001) and billed for a lower annual number of services (1,228, IQR 454–2,433 vs. 2,259, IQR 996–4,075, respectively p<0.001). After adjustment for covariates, women ophthalmologists billed for 1015 fewer services (95% confidence interval 1001–1029, p<0.001), and received $20,209.12 less in reimbursements than men (95% confidence interval −21,717.57 to −18,700.66, p<0.001). Women ophthalmologists billed for a lower number of services and received less in reimbursement from Medicare than men over time and across all categories of billing codes. Disparities persisted after controlling for physician and practice characteristics. Women ophthalmologists billed for a lower number of services and received less in reimbursement from Medicare than men over time and across most categories of billing codes. Disparities in reimbursement persisted after controlling for physician and practice characteristics.
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影响因子：
24
作者：
Raber, Inbar;Al Rifai, Mahmoud;McEvoy, John W.
通讯作者：
McEvoy, John W.
影响因子：
4.2
作者：
Ahmad, Sumayya;Ramulu, Pradeep;Klawe, Janek
通讯作者：
Klawe, Janek
DOI：
10.1097/iae.0000000000002942
发表时间：
2021-04-01
影响因子：
3.3
作者：
Reyes-Capo, Daniela P.;Yannuzzi, Nicolas A.;Sridhar, Jayanth
通讯作者：
Sridhar, Jayanth
影响因子：
8.1
作者：
Gong, Dan;Winn, Bryan J.;Al-Aswad, Lama A.
通讯作者：
Al-Aswad, Lama A.
影响因子：
8.1
作者：
Reddy, Ashvini K.;Bounds, Gregory W.;Thorne, Jennifer E.
通讯作者：
Thorne, Jennifer E.