Weill Cornell Medical College/NewYork-Presbyterian Hospital, 1300 York Avenue, New York, NY 10065 USA.
Weill Cornell Medical College/NewYork-Presbyterian Hospital, 1300 York Avenue, New York, NY 10065 USA.
J Plast Reconstr Aesthet Surg. 2021 Oct;74(10):2737-2743. doi: 10.1016/j.bjps.2021.03.011. Epub 2021 Mar 24.
Rising health care costs and the high number of uninsured Americans has led to the increasing popularity of a single payer alternative. While opinions of physicians at large have been studied, we present the first data examining the views of United States (U.S.) board-certified plastic surgeons on a single payer health care system and its implications for patients and practice.
A total of 3,431 US plastic and reconstructive surgeons were sent a 25-item Qualtrics survey and responses collected from September 1 to November 1, 2019. Independent variables included surgeon sociodemographic characteristics. The association between these and a preference for a single payer was evaluated using the logistic regression.
There was a 11% response rate (n = 383). The majority of respondents were in private practice (64.5%). Forty-four percent believed that it is the government's responsibility to ensure care is provided for all; 34% were willing to give up income in exchange for reduced paperwork and administrative burden. Sixty-three percent would not work the same number of hours under single payer. Private practice plastic surgeons were significantly less likely to favor single payer (95% CI: 0.19 and 0.76). Among academic plastic surgeons, 24% would consider leaving if single payer were enacted and 60% would decrease the reconstructive portion of their practice.
Most U.S. plastic and reconstructive surgeons do not support a single payer health care system. Its enactment could have sweeping implications for plastic surgeons nationwide, among the most significant being a shift from academic to private practice with a potential reduction in patient access to complex reconstructive procedures.
不断上涨的医疗保健成本和大量的未参保美国人导致单一支付者替代方案越来越受欢迎。虽然已经研究了普通医生的意见，但我们首次提供了美国（美国）认证的整形医生对单一支付者医疗保健系统及其对患者和实践影响的看法的数据。
总共向 3431 名美国整形和重建外科医生发送了 25 项 Qualtrics 调查，并于 2019 年 9 月 1 日至 11 月 1 日收集了答复。外科医生的社会人口统计学特征包括自变量。使用逻辑回归评估这些因素与单一支付者偏好之间的关联。
响应率为 11％（n=383）。大多数受访者在私人诊所工作（64.5％）。44％的人认为政府有责任确保为所有人提供护理；34％愿意放弃收入，以减少文书工作和行政负担。63％的人在单一付款人下不会工作相同数量的时间。私人执业整形外科医生不太可能赞成单一付款人（95％CI：0.19 和 0.76）。在学术整形外科医生中，如果实行单一付款人制度，有 24％的人会考虑离开，而 60％的人会减少其实践中的重建部分。
大多数美国整形和重建外科医生不支持单一付款人医疗保健系统。其颁布可能对全国整形外科医生产生广泛影响，其中最重要的是从学术到私人执业的转变，患者可能无法获得复杂的重建手术。
