Comparison of industry payments to psychiatrists and psychiatric advanced practice clinicians in the USA, 2021: a cross-sectional study.
Comparison of industry payments to psychiatrists and psychiatric advanced practice clinicians in the USA, 2021: a cross-sectional study.
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2021 年美国精神科医生和精神科高级实践临床医生的行业支付比较：一项横断面研究。
DOI：
10.1136/bmjopen-2023-081252
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发表时间：
2024
期刊：
影响因子：
2.9
通讯作者：
Rhee,TaehoGreg
中科院分区：
文献类型：
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作者：
Havlik,John;Ososanya,Lydia;Lee,MeganS;Wahid,Syed;Heyang,Michael;Sun,QiweiWilton;Ross,JosephS;Rhee,TaehoGreg
目的比较美国精神科医生和精神科高级实践临床医生（APC）的行业支付模式，并确定实践法律的范围如何影响这些模式。设计横断面研究。设置本研究使用了公开可用的美国医疗保险和医疗补助服务中心阳光法案开放支付数据库和国家计划和提供者枚举系统（NPPES）。2021年的数据库。所有精神科医生和精神科APC（细分为执业护士（NP）和临床护理专家（CNS））包括在任一数据库中。主要和次要结局指标接受行业付款的临床医生的数量和百分比以及收到的付款价值。还评估了按付款类型、付款来源和临床医生类型划分的总付款和交易数量。（61 011名精神科医生（71.7%），21 895名非专业人员（25.7%），2 147个国家统计局（2.5%）进行了审查; 16240名（26.6%）精神科医生从行业获得非研究性报酬，而NPs和CNSs分别为10802名（49.3%）和231名（10.7%）（两两比较p<0.001）。与精神科医生相比，精神科NP更有可能接受行业支付（发病率比（IRR），1.85（95% CI 1.81至1.88）; p<0.001））。与精神病医生相比，非专业人员更有可能获得> 100美元的报酬。（33.9% vs 14.6%; IRR，2.14（2.08 - 2.20）; p<0.001）和> 1000美元（5.3%对4.1%;内部回报率，1.29（1.20至1.38）; p<0.001），但不太可能接受> 10 000美元（0.4%对1.0%;内部回报率，0.39（0.31至0.49）; p<0.001）。执业范围“缩小”或“限制”的州的NP获得更频繁的付款（减少：内部回报率，1.22（1.18至1.26）;限制：内部收益率，1.26（1.22至1.30），均p<0.001）。结论精神科NPs接受行业报酬的可能性是精神科医生的近两倍，而精神科的CNSs获得付款的可能性不到一半。更广泛的执业范围的法律增加了精神科NPs接受付款的可能性，这与最近的专业不可知论研究中发现的情况相反。
ObjectivesTo compare industry payment patterns among US psychiatrists and psychiatric advanced practice clinicians (APCs) and determine how scope of practice laws has influenced these patterns.DesignCross-sectional study.SettingThis study used the publicly available US Centers for Medicare and Medicaid Services Sunshine Act Open Payment database and the National Plan and Provider Enumeration System (NPPES) database for the year 2021.ParticipantsAll psychiatrists and psychiatric APCs (subdivided into nurse practitioners (NPs) and clinical nurse specialists (CNSs)) included in either database.Primary and secondary outcome measuresNumber and percentage of clinicians receiving industry payments and value of payments received. Total payments and number of transactions by type of payment, payment source and clinician type were also evaluated.ResultsA total of 85 053 psychiatric clinicians (61 011 psychiatrists (71.7%), 21 895 NPs (25.7%), 2147 CNSs (2.5%)) were reviewed; 16 240 (26.6%) psychiatrists received non-research payment from industry, compared with 10 802 (49.3%) NPs and 231 (10.7%) CNSs (p<0.001) for pairwise comparisons). Psychiatric NPs were significantly more likely to receive industry payments compared with psychiatrists (incidence rate ratio (IRR), 1.85 (95% CI 1.81 to 1.88); p<0.001)). Compared with psychiatrists, NPs were more likely to receive payments of > United States Dollars (US) $) 100 (33.9% vs 14.6%; IRR, 2.14 (2.08 to 2.20); p<0.001) and > US$ 1000 (5.3% vs 4.1%; IRR, 1.29 (1.20 to 1.38); p<0.001) but less likely to receive > US$ 10 000 (0.4% vs 1.0%; IRR, 0.39 (0.31 to 0.49); p<0.001). NPs in states with ‘reduced’ or ‘restricted’ scope of practice received more frequent payments (reduced: IRR, 1.22 (1.18 to 1.26); restricted: IRR, 1.26 (1.22 to 1.30), both p<0.001).ConclusionsPsychiatric NPs were nearly two times as likely to receive industry payments as psychiatrists, while psychiatric CNSs were less than half as likely to receive payment. Stricter scope of practice laws increases the likelihood of psychiatric NPs receiving payment, the opposite of what was found in a recent specialty agnostic study.