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肿瘤多学科会诊中的医疗行业:开放支付数据库的三年分析及肿瘤专科比较

Medical industry at tumor board: Three-years analysis of the open payments database and comparison of oncologic specialties.

作者信息

Baadh Amanjit S, Patel Mikin, Patel Ketan, Ahmed Osman

机构信息

St. Paul Radiology, Department of Interventional Radiology, St. Paul, Minnesota.

Department of Interventional Radiology, Medical Center of Northwestern University, Chicago, Illinois.

出版信息

J Surg Oncol. 2018 Mar;117(4):551-557. doi: 10.1002/jso.24899. Epub 2017 Nov 22.

Abstract

BACKGROUND AND OBJECTIVES

To analyze and contrast medical industry payments across U.S. oncologic providers, including hematology-oncology (HO), surgical oncology (SO), interventional radiology (IR), and radiation oncology (RO).

METHODS

Open-payment-data for each provider including provider specialty, state of practice, industry payor, reason for payment, and amount was compiled for each transaction between 2013 and 2015. Total, mean, and median payment amounts per-provider were calculated for each specialty. Tukey's-method was used to identify and remove statistical outliers and Kruskal-Wallis-test with Bonferonni-post-hoc-analysis was used to evaluate for differences in total payments received per-provider across specialties. The percentage of providers accepting payments within each specialty were compared by Marascuilo's multiple-proportion-comparison.

RESULTS

Total aggregate payment amount (and number of transactions) for HO, SO, IR, and RO was $164 743 746 (778 007), $7 925 467 (15 031), $49 817 380 (44 939), and $13 643 739 (49 778), respectively. Corrected-median (and corrected-mean) payments-per-specialty were $676 ($1796), $330 ($1209), $487 ($1301), and $242 ($766). A significantly higher proportion of HO providers accepted payments than both RO (97% vs 80%, P < 0.0001) and IR (97% vs 78%, P < 0.0001). The mean total payment received per-provider differed significantly across specialties (P = 0.0001). HO providers, on average, received significantly more payment-per-provider during the study period (P < 0.001) compared to all others while RO and IR received significantly less (P < 0.0001).

CONCLUSIONS

Among industry payments made to oncologic providers, HO received the highest median and corrected-mean amounts along with the highest proportion of providers receiving open payments.

摘要

背景与目的

分析并对比美国肿瘤医疗服务提供者(包括血液肿瘤学(HO)、外科肿瘤学(SO)、介入放射学(IR)和放射肿瘤学(RO))所获得的医疗行业支付情况。

方法

整理了2013年至2015年期间各医疗服务提供者的公开支付数据,包括提供者专业、执业州、行业付款方、付款原因及金额。计算了每个专业每个提供者的总支付金额、平均支付金额和中位数支付金额。使用Tukey方法识别并去除统计异常值,采用Kruskal-Wallis检验及Bonferonni事后分析评估各专业每个提供者所获总支付金额的差异。通过Marascuilo多比例比较法比较各专业内接受支付的提供者比例。

结果

HO、SO、IR和RO的总支付金额(及交易数量)分别为164743746美元(778007笔)、7925467美元(15031笔)、49817380美元(44939笔)和13643739美元(49778笔)。各专业经校正的中位数(及经校正的平均数)支付金额分别为676美元(1796美元)、330美元(1209美元)、487美元(1301美元)和242美元(766美元)。接受支付的HO提供者比例显著高于RO(97%对80%,P<0.0001)和IR(97%对78%,P<0.0001)。各专业每个提供者所获平均总支付金额存在显著差异(P = 0.0001)。在研究期间,HO提供者平均每个提供者获得的支付显著多于其他所有专业(P<0.001),而RO和IR获得的支付显著较少(P<0.0001)。

结论

在向肿瘤医疗服务提供者支付的行业款项中,HO获得的中位数和经校正平均数金额最高,接受公开支付的提供者比例也最高。

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