Global Health Policy and Data Institute, San Diego, CA, United States of America.
Department of Anesthesiology, San Diego School of Medicine, University of California, San Diego, CA, United States of America.
PLoS One. 2021 Jun 2;16(6):e0252656. doi: 10.1371/journal.pone.0252656. eCollection 2021.
The Open Payments database reports payments made to physicians by industry. Given the potential for financial conflicts of interest relating to patient outcomes, further scrutiny of these data is valuable. Therefore, the objective of this study was to analyze physician-industry relationships by specialty type, payment type, geospatial trend, and longitudinal trend between 2014-2018. We conducted an observational, retrospective data analysis of payments from the Open Payments database for licensed United States physicians listed in the National Plan & Provider Enumeration System (NPPES). Datasets from 2013-2018 were joined using the Python programming language. Aggregation and sub-setting by characteristics of interest was done in R to calculate means and frequencies of reported general physician payments from industry across different specialties, locations, timeframes, and payment types. Normalization was applied for numbers of physicians or payments. Geospatial statistical hot spot analysis was conducted in ArcGIS. 51.73 million payment records were analyzed. In total, 50,047,930 payments were issued to 771,113 allopathic or osteopathic physicians, representing $8,702,631,264 transferred from industry to physicians over the five-year period between 2014 and 2018. The mean payment amount was $179, with a standard deviation of $12,685. Variability in physicians' financial relationships with industry were apparent across specialties, regions, time, and payment type. A limited match rate between records in the NPPES and Open Payments databases may have resulted in selection bias of trends related to physician characteristics. Further research is necessary, particularly in the context of changing industry payment trends and public perceptions of the appropriateness of these relationships.
开放支付数据库报告了行业向医生支付的款项。鉴于与患者结果相关的财务利益冲突的可能性，对这些数据进行进一步审查是有价值的。因此，本研究的目的是分析 2014-2018 年间按专业类型、支付类型、地理空间趋势和纵向趋势分析医生与行业的关系。我们对美国国家计划和提供者登记系统（NPPES）中列出的持照美国医生的开放支付数据库中的支付进行了观察性、回顾性数据分析。使用 Python 编程语言将 2013-2018 年的数据集合并。在 R 中按感兴趣的特征进行聚合和子集划分，以计算不同专业、地点、时间段和支付类型的行业向普通医生报告的总支付金额的平均值和频率。对医生人数或支付金额进行了标准化。在 ArcGIS 中进行了地理空间统计热点分析。分析了 5173 万笔支付记录。在 2014 年至 2018 年的五年期间，共向 771113 名全科医生或骨科医生发放了 50047930 笔款项，总计向医生转移了 8702631264 美元。平均支付金额为 179 美元，标准差为 12685 美元。医生与行业的财务关系在专业、地区、时间和支付类型上存在明显差异。NPPES 和开放支付数据库中的记录之间的匹配率有限，可能导致与医生特征相关的趋势存在选择偏差。需要进一步研究，特别是在行业支付趋势变化和公众对这些关系适当性的看法方面。
