Lee Kevin C, Chuang Sung-Kiang
Gen Dent. 2020 Jan-Feb;68(1):56-60.
The purpose of this retrospective, observational study was to characterize the amounts and types of healthcare industry payments made to dental care providers in 2017. Data were collected from the Open Payments database of the US Centers for Medicare & Medicaid Services. Dentists were classified as providing general services or services in 1 of 9 specialties recognized by the American Dental Association (prior to the recognition of dental anesthesiology). The value and nature of each payment made to providers were recorded, and descriptive statistics were calculated. Distributions across dental specialties were compared with analyses of variance. In 2017, US dentists received a total of 321,627 industry payments totaling $110,750,601. The most money was spent on service fees ($37,333,870; 33.7%), followed by consulting fees ($12,983,013; 11.7%) and royalties and licenses ($11,426,776; 10.3%). Each provider received a median payment of $63.27 (range, $0.21-$22,931,027.12) spread over 2 payments (range, 1-285). Participation rates among dental specialists ranged from 19% to 62%, and the highest rates were found among orthodontists (61.8%), oral and maxillofacial surgeons (55.7%), and periodontists (54.6%). The greatest median payments per provider were made to specialists in oral and maxillofacial radiology ($187.52), periodontics ($127.31), and oral and maxillofacial surgery ($123.39). The mean number (P < 0.01) and amount of payments (P < 0.01) per provider differed significantly across all specialties. The majority of dentists in this study received less than $200; however, the distribution of payments was positively skewed by a few top earners. The effect of these payments on clinical practice remains to be determined.
这项回顾性观察研究的目的是描述2017年支付给牙科护理提供者的医疗行业款项的金额和类型。数据从美国医疗保险和医疗补助服务中心的公开支付数据库中收集。牙医被分类为提供一般服务或美国牙科协会认可的9个专科之一的服务（在牙科麻醉学被认可之前）。记录支付给提供者的每笔款项的价值和性质，并计算描述性统计数据。通过方差分析比较各牙科专科的分布情况。2017年，美国牙医共收到321,627笔行业款项，总计110,750,601美元。支出最多的是服务费（37,333,870美元；33.7%），其次是咨询费（12,983,013美元；11.7%）以及版税和许可费（11,426,776美元；10.3%）。每位提供者收到的款项中位数为63.27美元（范围为0.21美元至22,931,027.12美元），分2笔支付（范围为1至285笔）。牙科专科医生的参与率在19%至62%之间，正畸医生（61.8%）、口腔颌面外科医生（55.7%）和牙周病医生（54.6%）的参与率最高。每位提供者获得的款项中位数最高的是口腔颌面放射科专科医生（187.52美元）、牙周病专科医生（127.31美元）和口腔颌面外科专科医生（123.39美元）。所有专科中，每位提供者收到的款项平均数（P < 0.01）和金额（P < 0.01）存在显著差异。本研究中的大多数牙医收入低于200美元；然而，少数高收入者使款项分布呈正偏态。这些款项对临床实践的影响仍有待确定。
