Department of Ophthalmology, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona.
Department of Neuroscience, Brigham Young University, Provo, Utah.
Ophthalmology. 2023 Sep;130(9):983-992. doi: 10.1016/j.ophtha.2023.05.006. Epub 2023 May 9.
To quantify trends in ophthalmology practice consolidation in the United States.
A retrospective cross-sectional study.
Providers in the Centers for Medicare and Medicaid Services (CMS) National Downloadable File with a primary specialty designation of ophthalmology.
We used the CMS database to determine national practice consolidation trends in ophthalmology on individual physician and group practice levels and analyzed by region, sex, and years spent in practice. We used the Cochran-Armitage test to determine the statistical significance of practice size differences between 2015 and 2022.
Temporal practice size trends for physicians and practices in ophthalmology and regional, sex-specific, and age-related trends.
Between 2015 and 2022, the number of ophthalmologists decreased from 17 656 to 17 615 (-0.2%), whereas the number of practices decreased from 7149 to 5890 (-18%). The percentage of ophthalmologists in practices of 1 to 2 members decreased from 35% to 28%, whereas those in groups of 50 or more increased from 7% to 11%. The percentage of practices with 1 to 2 members decreased from 75% to 71%, and those with 50 or more increased from 0.2% to 0.4%. Consolidation trends were significant on individual ophthalmologist (P < 0.001) and group practice (P < 0.001) levels. All regions, sexes, and subgroups of years spent in practice demonstrated consolidation (P < 0.001). The Northeast showed the greatest increase in groups of 50 or more physicians (+7%) between 2015 and 2022. Proportionally fewer female than male ophthalmologists were associated with practice sizes of 1 to 2 members in 2015 (29% and 36%, respectively) and 2022 (23% and 30%, respectively). Proportionally fewer ophthalmologists with 0 to 10 years of experience in practice were associated with practice sizes of 1 to 2 members than those with more than 30 years in practice in 2015 (18% and 48%, respectively) and 2022 (14% and 40%, respectively).
Ophthalmology has undergone practice consolidation from 2015 to 2022. A decrease in the proportion of physicians affiliated with smaller practice sizes seems to have occurred.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
量化美国眼科实践整合的趋势。
回顾性横断面研究。
医疗保险和医疗补助服务中心（CMS）国家可下载文件中主要专业为眼科的提供者。
我们使用 CMS 数据库确定眼科医生和团体实践层面上的全国实践整合趋势，并按地区、性别和从业年限进行分析。我们使用 Cochran-Armitage 检验来确定 2015 年至 2022 年之间实践规模差异的统计学意义。
眼科医生和实践的时间实践规模趋势以及区域、性别特异性和年龄相关性趋势。
2015 年至 2022 年间，眼科医生的数量从 17656 人减少到 17615 人（-0.2%），而实践的数量从 7149 人减少到 5890 人（-18%）。1 至 2 名成员的实践中眼科医生的比例从 35%下降到 28%，而 50 名或更多成员的实践中眼科医生的比例从 7%上升到 11%。1 至 2 名成员的实践比例从 75%下降到 71%，而 50 名或更多成员的实践比例从 0.2%上升到 0.4%。眼科医生个体（P<0.001）和团体实践（P<0.001）层面上的整合趋势均具有统计学意义。所有地区、性别和从业年限亚组均表现出整合（P<0.001）。2015 年至 2022 年间，东北地区 50 名或更多医生的团体数量增加最多（+7%）。与 2015 年（29%和 36%）和 2022 年（23%和 30%）相比，女性眼科医生与 1 至 2 名成员的实践规模相关的比例较低。与从业 30 年以上的医生相比，从业 0 至 10 年的眼科医生与 1 至 2 名成员的实践规模相关的比例较低，2015 年（18%和 48%）和 2022 年（14%和 40%）。
从 2015 年至 2022 年，眼科实践已经进行了整合。与较小规模实践相关的医生比例似乎有所下降。
在本文末尾的脚注和披露中可以找到专有或商业披露信息。
