2013 年至 2017 年皮肤科医生放疗使用的变化。

Changes in Use of Radiotherapy Among Dermatologists From 2013 to 2017.

机构信息

Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas.

Department of Internal Medicine, Dell Medical School, The University of Texas at Austin.

出版信息

JAMA Dermatol. 2021 Mar 1;157(3):322-325. doi: 10.1001/jamadermatol.2020.4931.

DOI:10.1001/jamadermatol.2020.4931

PMID:33355610

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7758818/

Abstract

IMPORTANCE

Concerns have been raised about the use of radiotherapy (RT) by dermatologists. Little is known about temporal trends in payment for RT among dermatologists.

OBJECTIVE

To characterize changes in RT use and payment among dermatologists treating patients enrolled in Medicare.

DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional, population-based retrospective analysis of dermatologists submitting Medicare claims was conducted. Dermatologists identified in the 2013-2017 Medicare Physician and Other Supplier Public Use File, which includes information on fee-for-service payments and service use among physicians caring for Medicare beneficiaries, were included in the analysis. The study was conducted from March 18 to October 22, 2020.

MAIN OUTCOMES AND MEASURES

Numbers and types of RT, current terminology codes billed by dermatologists, number of dermatologists providing RT services, total payments and median payments per dermatologist for RT services, total services and median services per dermatologist, and number of dermatologists billing for both RT and Mohs micrographic surgery services.

RESULTS

From 2013 to 2017, dermatologists billed RT codes, which included RT planning, preparation, delivery, and management services with varying levels of complexity. The number of dermatologists using RT increased from 115 to 198 between 2013 to 2017. Total payments and total services for RT have fluctuated over time. Median payments per dermatologist and median services provided per dermatologist for RT reached their highest level in 2017 ($80 810 and 629 services). In 2013, RT delivery was the highest reimbursed RT service type (total paid, $9 121 505). By 2017, clinical treatment planning and simulation was the highest reimbursed service type (total paid, $20 288 796).

CONCLUSIONS AND RELEVANCE

The findings of this cross-sectional study indicate that dermatologist use of RT continues to increase. A wide variety of RT services are billed by dermatologists. Further research is needed to ensure expanded use is safe, efficacious, and cost-effective.

摘要

重要性

人们对皮肤科医生使用放射治疗（RT）提出了担忧。关于皮肤科医生 RT 支付的时间趋势，知之甚少。

目的

描述接受 Medicare 患者治疗的皮肤科医生中 RT 使用和支付的变化。

设计、设置和参与者：对 2013-2017 年 Medicare 医师和其他供应商公共使用文件中提交医疗保险索赔的皮肤科医生进行了横断面、基于人群的回顾性分析。该分析包括 2013-2017 年 Medicare 医师和其他供应商公共使用文件中识别的皮肤科医生，该文件包括为 Medicare 受益人提供服务的医生的费用支付和服务使用信息。研究于 2020 年 3 月 18 日至 10 月 22 日进行。

主要结果和措施

RT 的数量和类型、皮肤科医生开具的当前术语代码、提供 RT 服务的皮肤科医生数量、RT 服务的总支付和每位皮肤科医生的中位数支付、每位皮肤科医生的总服务和中位数服务以及同时开具 RT 和 Mohs 显微外科手术服务的皮肤科医生数量。

结果

从 2013 年到 2017 年，皮肤科医生开具了 RT 代码，这些代码包括 RT 计划、准备、交付和管理服务，具有不同程度的复杂性。使用 RT 的皮肤科医生人数从 2013 年到 2017 年从 115 人增加到 198 人。RT 的总支付和总服务随时间波动。每位皮肤科医生的中位数支付和每位皮肤科医生提供的中位数服务在 2017 年达到最高水平（80810 美元和 629 项服务）。2013 年，RT 交付是最高报销的 RT 服务类型（总支付，9121505 美元）。到 2017 年，临床治疗计划和模拟是最高报销的服务类型（总支付，20288796 美元）。