Differences in Physician Income by Gender in a Multiregion Survey
Differences in Physician Income by Gender in a Multiregion Survey
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DOI：
10.1007/s11606-018-4462-2
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发表时间：
2018-09-01
影响因子：
5.7
通讯作者：
Friedberg, Mark W.
中科院分区：
文献类型：
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作者：
Apaydin, Eric A.;Chen, Peggy G. C.;Friedberg, Mark W.
以前的研究记录了男性和女性医生之间的收入差异。然而，这些差异的含义尚不清楚，因为以前的研究缺乏关于工作时间的数量和组成的详细数据。我们试图通过一项新的医生工作和收入调查的数据来确定这些收入差异的来源，比较男性和女性医生之间的收入差异，我们估计了男性和女性医生之间未经调整的收入差异。然后，我们调整了这些差异的总工作时间，工作时间的组成，病人护理时间的百分比，提供程序，专业，补偿类型，年龄，执业年数，种族，民族，国家和实践的随机效应。我们调查了656名医生在30个实践中，在6个州，收到439份答复（67%回应率）：男性263人，女性176人。自报年收入。男性医师的年收入显著高于女性医师（平均值297，641美元与206，751美元;差异90，890美元，95% CI 27，769美元至154，011美元），工作总时间显著增加（平均值2470 vs. 2074;差异396，95% CI 250 - 542）和更多的患者护理时间（平均值2203 vs. 1845;差异358，95% CI 212 - 505）。男性医生不太可能比女性医生专门从事初级保健（49.1%对70.5%），但更有可能在全身麻醉（33.1%对15.5%）或无全身麻醉（84.3%对73.1%）的情况下进行手术。调整后，男性医生的收入比女性医生的收入高27，404美元（95%CI 3120美元至51，688美元）。对多种可能的混杂因素（包括工作时间的数量和组成）进行调整，可以解释男性和女性医生之间约70%的未调整收入差异; 30%仍然无法解释。可能需要进行更多的研究和专门努力，以确定和解决这些无法解释的差异的原因。
Previous studies have documented income differences between male and female physicians. However, the implications of these differences are unclear, since previous studies have lacked detailed data on the quantity and composition of work hours. We sought to identify the sources of these income differences using data from a novel survey of physician work and income.To compare differences in income between male and female physicians.We estimated unadjusted income differences between male and female physicians. We then adjusted these differences for total hours worked, composition of work hours, percent of patient care time spent providing procedures, specialty, compensation type, age, years in practice, race, ethnicity, and state and practice random effects.We surveyed 656 physicians in 30 practices in six states and received 439 responses (67% response rate): 263 from males and 176 from females.Self-reported annual income.Male physicians had significantly higher annual incomes than female physicians (mean $297,641 vs. $206,751; difference $90,890, 95% CI $27,769 to $154,011) and worked significantly more total hours (mean 2470 vs. 2074; difference 396, 95% CI 250 to 542) and more patient care hours (mean 2203 vs. 1845; difference 358, 95% CI 212 to 505) per year. Male physicians were less likely than female physicians to specialize in primary care (49.1 vs. 70.5%), but more likely to perform procedures with (33.1 vs. 15.5%) or without general anesthesia (84.3 vs. 73.1%). After adjustment, male physicians' incomes were $27,404 (95% CI $3120 to $51,688) greater than female physicians' incomes.Adjustment for multiple possible confounders, including the number and composition of work hours, can explain approximately 70% of unadjusted income differences between male and female physicians; 30% remains unexplained. Additional study and dedicated efforts might be necessary to identify and address the causes of these unexplained differences.