《医疗保险人群中鼻内镜鼻窦清创术的趋势》。
Trends in Endoscopic Sinonasal Debridement in the Medicare Population.
机构信息
Michigan State University College of Human Medicine, Lansing, MI.
Department of Head and Neck Surgery, Kaiser Permanente Oakland & Richmond Medical Centers, Oakland, CA.
出版信息
Perm J. 2021 May;25. doi: 10.7812/TPP/20.110.
INTRODUCTION
Nasal/sinus endoscopy with biopsy/polypectomy/debridement, or Current Procedure Terminology code 31237, is one of the top 10 most frequent and highest billed otolaryngology procedures among Medicare patients. We analyzed temporal and geographic trends in endoscopic debridement, and correlated them with sinus surgery and balloon sinuplasty trends.
METHODS
Medicare Part-B National Summary Data Files were analyzed from 2000 to 2016 for temporal trends of endoscopic debridement. Medicare Physician and Other Supplier Public Use Files detailing provider information were collected and analyzed from 2012 to 2016. Individual providers performing a reportable number of procedures were included. Linear regression was used to correlate endoscopic debridement, sinus surgery, and balloon sinuplasty procedures.
RESULTS
Between 2000 and 2016, the number of endoscopic debridement procedures increased from 31,579 to 79,762 (6.0% average annual growth). The annual total payments increased from $5,944,582 to $19,438,956 (8.4% average annual growth), with average allowed charge per procedure increasing from $188.24 to $243.71. The greatest and least number of debridement procedures occurred in the Southeast (12,703) and New England (1810) regions, respectively. There was a positive correlation between providers (n = 752) performing endoscopic debridement and sinus surgery (r = 0.31, p < 0.001), which was similar to providers performing endoscopic debridement and balloon sinuplasty (r = 0.29, P < 0.001).
CONCLUSION
Otolaryngologists continue to perform increasing numbers of endoscopic debridements and receive increasing payments. There is some geographic variation in these trends. Among individual providers, there was a positive correlation between the number of endoscopic debridement procedures and both the number of balloon sinuplasty and sinus surgery procedures.
简介
鼻/鼻窦内镜检查伴活检/息肉切除术/清创术，或当前操作术语代码 31237，是 Medicare 患者中十大最常见和最高计费的耳鼻喉科手术之一。我们分析了内镜清创术的时间和地理趋势，并将其与鼻窦手术和球囊鼻窦扩张术的趋势相关联。
方法
从 2000 年到 2016 年，分析 Medicare 第 B 部分国家汇总数据文件中的内镜清创术时间趋势。从 2012 年到 2016 年，收集并分析了 Medicare 医师和其他供应商公共使用文件，详细说明了供应商信息。包括报告数量程序的个人供应商。使用线性回归来关联内镜清创术、鼻窦手术和球囊鼻窦扩张术程序。
结果
在 2000 年至 2016 年间，内镜清创术的数量从 31579 例增加到 79762 例（年平均增长率为 6.0%）。年度总支付额从 5944582 美元增加到 19438956 美元（年平均增长率为 8.4%），每次手术的平均允许收费从 188.24 美元增加到 243.71 美元。清创术数量最多的地区是东南部（12703 例），数量最少的地区是新英格兰（1810 例）。开展内镜清创术的供应商（n = 752）与开展鼻窦手术的供应商（r = 0.31，p < 0.001）之间存在正相关关系，这与开展内镜清创术和球囊鼻窦扩张术的供应商之间的关系相似（r = 0.29，P < 0.001）。
结论
耳鼻喉科医生继续进行越来越多的内镜清创术，并获得越来越多的报酬。这些趋势在地理上存在一定差异。在个别供应商中，内镜清创术的数量与球囊鼻窦扩张术和鼻窦手术的数量之间存在正相关关系。
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