Gender variation in Medicare utilization and payments in gynecologic oncology
Gender variation in Medicare utilization and payments in gynecologic oncology
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DOI：
10.1016/j.ygyno.2019.06.007
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发表时间：
2019-09-01
影响因子：
4.7
通讯作者：
Havrilesky, Laura J.
中科院分区：
文献类型：
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作者：
Lim, Stephanie L.;Puechl, Allison M.;Havrilesky, Laura J.
目标. Medicare提供者使用和支付数据：医生和其他提供者公共使用文件（POSPUF）和Medicare医生和其他提供者国家提供者标识符（POS NPI）汇总报告是来自Medicare和Medicaid服务中心的公开文件，其中包括向照顾按服务收费的Medicare接受者的提供者支付的费用。本研究的目的是分析妇科肿瘤医生的医疗保险报销的差异，注意提供者的性别和时间在实践中的差异。2015年POSPUF和POS NPI分析了妇科肿瘤学家。我们搜索了外部公开可用的数据源，以确认子专业，并确定每个提供者的执业年限。评估和管理（E&M）和程序/手术代码进行了分析，药物输送代码被排除在外，由于不同的收费设施/医院。POS NPI文件包括733名妇科肿瘤医生提供者，总付款额为55，626，739美元。女性提供者占妇科肿瘤医生的39%，获得31%的报销（30%的E&M报销和24%的手术报销）。在最初的十年里，女性提供者占提供者的58%，占报销服务的52%，相比之下，38%的提供者/ 26%的报销服务（11-20年），18%的提供者/19%的报销服务（>20年）。男性妇科肿瘤学家比女性同行提供更多的医疗保险服务。在最资深和最初级的服务提供者中，男女提供的服务数量相当，在职业生涯中期的服务提供者中，服务和报销方面存在性别差距。(C)2019由Elsevier Inc.出版
Objectives. The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF) and Medicare Physician and Other Supplier National Provider Identifier (POS NPI) Aggregate Report are publicly available files from the Center for Medicare and Medicaid Services that include payments to providers who care for fee-for-service Medicare recipients. The aim of this study was to analyze variability in gynecologic oncologists' Medicare reimbursements, with attention to differences in provider gender and time in practice.Methods. The 2015 POSPUF and POS NPI were analyzed with respect to gynecologic oncologists. We searched external publicly available data sources to confirm subspecialty and to determine each provider's number of years in practice. Evaluation and management (E&M) and procedure/surgery codes were analyzed; drug delivery codes were excluded due to variability in billing by facility/hospital.Results. The POS NPI file included 733 gynecologic oncologist providers receiving $55,626,739 in total payments. Female providers comprised 39% of gynecologic oncologists and received 31% of reimbursements (30% of E&M reimbursements and 24% of surgical reimbursements). During the first ten years in practice, female providers comprised 58% of providers and accounted for 52% of reimbursed services, compared to 38% of providers/ 26% of reimbursed services (11-20 years), and 18% of providers/19% of reimbursed services (>20 years).Conclusion. Male gynecologic oncologists perform more Medicare services than their female counterparts. There is a comparable number of services performed between genders among both the most senior and the most junior providers, with a gender gap in services and reimbursements among mid-career providers. (C) 2019 Published by Elsevier Inc.