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介入放射医师的性别临床实践模式。

Clinical Practice Patterns of Interventional Radiologists by Gender.

机构信息

Department of Radiology, NYU Langone Medical Center, 660 First Ave, 3rd Fl, New York, NY 10016.

Department of Radiology, Albany Medical College, Albany, NY.

出版信息

AJR Am J Roentgenol. 2019 Oct;213(4):867-874. doi: 10.2214/AJR.19.21321. Epub 2019 Jul 3.

Abstract

Given recent specialty attention to workforce diversity, we aimed to characterize potential gender differences in the practice patterns of interventional radiologists (IRs). Using Medicare claims data, we identified IRs on the basis of the distribution of their billed clinical work effort and descriptively characterized practice patterns by gender. Women represented 8.2% (241/2936) of all IRs identified nationally. Female representation varied geographically (≤ 2% in nine states, ≥ 20% in three states) and by career stage (9.4% among early-career IRs and 6.4% among late-career IRs; 18.8% among early-career IRs in the Northeast). For both female IRs and male IRs, interventional case mixes were similar across service categories (e.g., venous and hemodialysis access, arterial and venous interventions, biopsies and drainages) and by procedural complexity (e.g., 5.7% vs 4.3% for low-complexity procedures and 59.5% vs 61.3% for high-complexity procedures). Average patient complexity scores were also similar for female (2.7 ± 12 [SD]) and male (2.8 ± 12) IRs. Female IRs spent slightly lower portions of their work effort rendering invasive services (66.5% vs 70.0%, respectively) and noninvasive diagnostic imaging (19.0% vs 22.2%) than male IRs but spent more time in evaluation and management clinical visits (14.5% vs 7.9%). Both female IRs and male IRs rendered a majority of their services to female patients (53.4% vs 53.1%). Although women remain underrepresented in interventional radiology, female IRs' interventional case composition, procedural complexity, and patient complexity are similar to those of their male colleagues. Female IRs' higher proportion of evaluation and management clinical visits supports the specialty's increased focus on longitudinal care so that interventional radiology will thrive alongside other clinical specialties.

摘要

鉴于最近对劳动力多样性的专业关注,我们旨在描述介入放射学家(IR)实践模式中的潜在性别差异。 我们使用医疗保险索赔数据,根据其计费临床工作投入的分布确定 IR,并按性别描述性地描述实践模式。 全国范围内,女性占所有 IR 的 8.2%(241/2936)。女性的代表性在地理上有所不同(9 个州≤2%,3 个州≥20%),且在职业阶段也有所不同(早期职业生涯的 IR 为 9.4%,晚期职业生涯的 IR 为 6.4%;东北的早期职业生涯的 IR 为 18.8%)。对于女性和男性 IR,介入病例组合在服务类别(例如静脉和血液透析通路、动脉和静脉介入、活检和引流)和程序复杂性(例如低复杂性程序为 5.7%,高复杂性程序为 59.5%)方面相似。女性和男性 IR 的平均患者复杂程度评分也相似(分别为 2.7±12[SD]和 2.8±12)。女性 IR 花费的侵入性服务(分别为 66.5%和 70.0%)和非侵入性诊断成像(分别为 19.0%和 22.2%)的工作投入比例略低,但在评估和管理临床就诊中花费的时间更多(分别为 14.5%和 7.9%)。女性和男性 IR 都将大部分服务提供给女性患者(分别为 53.4%和 53.1%)。 尽管女性在介入放射学领域的代表性仍然不足,但女性 IR 的介入病例构成、程序复杂性和患者复杂性与男性同事相似。女性 IR 评估和管理临床就诊的比例较高,支持该专业对纵向护理的重视,以便介入放射学与其他临床专业一起蓬勃发展。

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