Kokabi Nima, Junn Jacqueline C, Xing Minzhi, Hemingway Jennifer, Hughes Danny R, Duszak Richard
Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
J Am Coll Radiol. 2017 Mar;14(3):418-425.e2. doi: 10.1016/j.jacr.2016.10.010. Epub 2017 Jan 9.
To evaluate characteristics of nonresearch industry payments to radiologists and associations with regional diagnostic imaging utilization.
Using 2014 CMS Open Payment data, all disclosed nonresearch-related industry payments to radiologists were identified. Health Resources and Services Administration Area Health Resources Files were used to identify actual and population-weighted numbers of radiologists by state. Utilizing the 5% random beneficiary sample CMS Research Identifiable Files from 2014, average Medicare imaging spending per beneficiary in each state was calculated. Average frequency and dollar amounts of nonresearch nonroyalty payments to radiologists were calculated at the state level. Using the Pearson correlation coefficient, the relationship between frequency and amounts of nonresearch payments to radiologists versus per-beneficiary Medicare imaging spending was evaluated at the state level.
Overall, 2,008 radiologists (1,670 diagnostic, 338 interventional) received nonresearch nonroyalty payments from industry, representing 5.2% of all 38,857 radiologists nationwide. A total of 4,975 individual transfers translated to 2.5 ± 1.3 discrete payments per receiving radiologist with a mean of $432 ± $1,976 (median $26; range $1-$34,050). Food and beverage expenses constituted the vast majority of disclosed transfers (4,111; 83%), followed by travel and lodging (444; 9%), consulting fees (279; 6%), and educational expenses (51; 1%). Considerable geographic variation in payments was observed, ranging from 0% of radiologists in Vermont to 12.9% in the District of Columbia. No correlation was identified between average per-beneficiary Medicare imaging spending and the proportion of nonresearch-funded radiologists in each state (r = 0.06). Similarly, no correlation was identified between average per-beneficiary Medicare imaging spending and the average nonresearch transfer amount to radiologists in each state (r = -0.08).
In 2014, only a small minority of United States radiologists received nonresearch payments from industry. At the state level, medical imaging utilization does not seem to be influenced by such financial relationships.
评估非研究行业向放射科医生支付款项的特征以及与区域诊断成像利用情况的关联。
利用2014年医疗保险和医疗补助服务中心（CMS）的公开支付数据，识别出所有披露的与研究无关的行业向放射科医生支付的款项。使用卫生资源与服务管理局的区域卫生资源文件，按州确定放射科医生的实际人数和按人口加权后的人数。利用2014年5%的随机受益样本CMS研究可识别文件，计算每个州每位医疗保险受益人的平均影像支出。在州层面计算向放射科医生支付的非研究非版税款项的平均频率和金额。使用Pearson相关系数，在州层面评估向放射科医生支付的非研究款项的频率和金额与每位受益人的医疗保险影像支出之间的关系。
总体而言，2008名放射科医生（1670名诊断放射科医生，338名介入放射科医生）接受了行业的非研究非版税支付，占全国38857名放射科医生总数的5.2%。总共4975笔个人转账相当于每位收款放射科医生有2.5±1.3笔离散支付，平均金额为432±1976美元（中位数26美元；范围1 - 34050美元）。食品和饮料费用占披露转账的绝大部分（4111笔；83%），其次是差旅费和住宿费（444笔；9%）、咨询费（279笔；6%）以及教育费用（51笔；1%）。观察到支付情况存在显著的地理差异，从佛蒙特州0%的放射科医生到哥伦比亚特区12.9%的放射科医生不等。未发现每个州每位受益人的医疗保险影像平均支出与非研究资金资助的放射科医生比例之间存在相关性（r = 0.06）。同样，也未发现每个州每位受益人的医疗保险影像平均支出与向放射科医生支付的非研究平均转账金额之间存在相关性（r = -0.08）。
2014年，美国只有一小部分放射科医生接受了行业的非研究支付。在州层面，医学影像利用似乎不受此类财务关系的影响。
