Female Pelvic Medicine and Reconstructive Surgery, Denver Health and Hospital Authority, Denver, and the University of Colorado School of Medicine, Aurora, Colorado; MJW Technical Services, Amherst, New York; and Cat Drop Foundation, Drachten, The Netherlands.
Obstet Gynecol. 2018 Jul;132(1):9-17. doi: 10.1097/AOG.0000000000002684.
To evaluate financial relationships between obstetrician-gynecologists (ob-gyns) and industry, including the prevalence, magnitude, and the nature of payments.
We conducted a cross-sectional study in which we obtained a list of industry contributions to U.S. obstetricians and gynecologists through the Centers for Medicare and Medicaid Services Open Payments Database from August 1, 2013, to December 31, 2015. These data were cross-referenced with the entire cohort of practicing obstetricians and gynecologists, who were identified using the National Provider Identification database, because not all practicing ob-gyns received payments. These payments were analyzed with respect to 1) types of payments, 2) demographic attributes of health care providers receiving payments, and 3) comparisons between obstetrician and gynecologist subspecialties. Continuous data were compared using the Mann-Whitney test for variables that were not normally distributed and with the t test for variables that are normally distributed.
A total of 517,077 nonresearch payments, totaling $79,965,244, were made to 23,292 ob-gyns. Physicians receiving payments were predominantly female, younger than 65 years old, allopathic physicians who graduated from U.S. medical schools in the late 1990s, and were board-certified subspecialists (P<.001 for all). Half of all ob-gyns received payments of varying amounts from drug manufacturers, device manufacturers, or both, with most of the payments for honoraria, faculty compensation, or consulting. Female pelvic medicine and reconstructive surgery physicians received the largest median dollar amount; maternal-fetal medicine physicians received the smallest.
Obstetricians and gynecologists receive a substantial amount of payments from industry. Most of these payments were for honoraria, faculty compensation, or consulting and totaled less than $400 per health care provider. Although this total amount is less than typically received by surgical providers, including orthopedic surgeons who account for the highest compensated group in total and mean industry payments, the median payment value for obstetrics and gynecology subspecialists surpasses the median payment to orthopedic surgeons. These financial relationships warrant further exploration with future research.
评估妇产科医生（ob-gyns）与行业之间的财务关系，包括其存在的普遍性、规模以及支付的性质。
我们进行了一项横断面研究，从 2013 年 8 月 1 日至 2015 年 12 月 31 日，通过医疗保险和医疗补助服务中心的公开支付数据库获取了美国妇产科医生行业贡献的清单。这些数据与通过国家提供者身份识别数据库确定的所有执业妇产科医生的整个队列进行了交叉引用，因为并非所有执业 ob-gyns 都收到了付款。根据以下三个方面分析了这些付款：1）付款类型；2）收到付款的医疗服务提供者的人口统计学属性；3）妇产科亚专业之间的比较。对于非正态分布的变量，使用 Mann-Whitney 检验进行比较，对于正态分布的变量，使用 t 检验进行比较。
共向 23,292 名妇产科医生支付了 79,965,244 美元的非研究性款项，共计 517,077 笔。收到付款的医生主要为女性，年龄在 65 岁以下，是毕业于 20 世纪 90 年代末的美国医学院的西医，并获得了委员会认证的亚专科医师（所有项目均<.001）。一半的妇产科医生从药品制造商、器械制造商或两者那里收到了不同金额的款项，其中大部分款项用于支付酬金、教职员工薪酬或咨询费。女性盆底医学和重建外科医生收到的中位数美元金额最大；母胎医学医生收到的金额最小。
妇产科医生从行业获得了大量的付款。这些款项中的大多数是酬金、教职员工薪酬或咨询费，每位医疗服务提供者的总额不到 400 美元。尽管这一总额低于通常由外科医生（包括骨科医生，他们在行业总支付和平均支付中属于最高补偿群体）获得的报酬，但妇产科亚专科医生的中位数付款价值超过了骨科医生的中位数付款价值。这些财务关系值得进一步研究。
