School of Medicine , Tohoku University, Sendai , Japan.
School of Medicine , Hamamatsu University, Hamamatsu , Japan.
J Am Soc Nephrol. 2023 Oct 1;34(10):1709-1720. doi: 10.1681/ASN.0000000000000172. Epub 2023 Jul 25.
Concerns about the financial relationships between nephrologists and the health care industry have been reported in the United States over the past decade. However, since the 2014 launch of the federal transparency database, Open Payments, few documents have explored the whole picture of research and nonresearch payments to US nephrologists from industry sources. In this study, the authors found that 87% of nephrologists have received nonresearch payments, and the aggregate amount of these payments has been increasing since 2014. Only 12% of nephrologists received research payments; these recipients were disproportionately male. In addition, the top 5% of nephrologists receiving nonresearch funds received 81% of all such payments. Nonresearch payments were larger among male nephrologists than among female nephrologists and increased by 8% annually among male nephrologists between 2014 and 2019.
Financial relationships between nephrologists and the health care industry have been a concern in the United States over the past decade.
To evaluate industry payments to nephrologists, we conducted a cross-sectional study examining nonresearch and research payments to all US nephrologists registered in the National Plan and Provider Enumeration System between 2014 and 2021, using the Open Payments database. Payment data were descriptively analyzed on the basis of monetary value, and payment trends were evaluated by using a generalized estimating equations model.
From 2014 through 2021, 10,463 of 12,059 nephrologists (87%) received at least one payment from the US health care industry, totaling $778 million. The proportion of nephrologists who did not receive nonresearch payments varied each year, ranging from 38% to 51%. Nonresearch payments comprised 22% ($168 million) of overall industry payments in monetary value but 87% in the number of payments. Among those receiving payments, the median per-physician 8-year aggregated payment values were $999 in nonresearch payments and $102,329 in associated research payments. Male nephrologists were more likely than female nephrologists to receive research payments, but the per-physician amount did not differ. However, nonresearch payments were three times larger for male nephrologists and increased by 8% annually between 2014 and 2019 among male nephrologists but remained stable among female nephrologists. The top 5% of nephrologists receiving nonresearch payments received 81% of all such payments.
Between 2014 and 2021, 87% of US nephrologists received at least one payment from the health care industry. Notably, nonresearch payments to nephrologists have been increasing since the Open Payments database's 2014 launch. Male nephrologists were more likely than female nephrologists to receive research payments.
声明：过去十年，美国一直对肾病学家与医疗保健行业之间的财务关系表示关注。然而，自 2014 年联邦透明度数据库“开放支付”（Open Payments）推出以来，几乎没有文件探讨过美国肾病学家从行业来源获得的研究和非研究支付的全貌。在这项研究中，作者发现 87%的肾病学家接受了非研究支付，自 2014 年以来，这些支付的总额一直在增加。只有 12%的肾病学家接受了研究支付；这些接受者中男性不成比例。此外，接受非研究资金的前 5%的肾病学家获得了所有此类支付的 81%。男性肾病学家收到的非研究款项多于女性肾病学家，而且在 2014 年至 2019 年间，男性肾病学家的非研究款项每年增加 8%。
背景：过去十年，美国一直对肾病学家与医疗保健行业之间的财务关系表示关注。
方法：为了评估行业对肾病学家的支付情况，我们对 2014 年至 2021 年间在美国国家计划和提供者登记系统注册的所有美国肾病学家进行了横断面研究，使用了“开放支付”数据库。根据货币价值对非研究和研究支付数据进行描述性分析，并使用广义估计方程模型评估支付趋势。
结果：从 2014 年到 2021 年，12059 名肾病学家中有 10463 名（87%）从美国医疗保健行业获得了至少一笔款项，总计 7.78 亿美元。每年没有收到非研究支付的肾病学家比例各不相同，范围在 38%至 51%之间。非研究支付占整体行业支付的 22%（1.68 亿美元），但在支付数量上占 87%。在收到付款的人中，每位医生 8 年的累计付款中位数为非研究付款 999 美元，相关研究付款 102329 美元。男性肾病学家比女性肾病学家更有可能获得研究支付，但金额没有差异。然而，男性肾病学家的非研究支付金额是女性的三倍，并且在 2014 年至 2019 年间每年增加 8%，而女性肾病学家的非研究支付则保持稳定。前 5%接受非研究支付的肾病学家获得了所有此类支付的 81%。
结论：2014 年至 2021 年间，87%的美国肾病学家至少收到了一笔来自医疗保健行业的付款。值得注意的是，自“开放支付”数据库 2014 年推出以来，肾病学家的非研究支付一直在增加。男性肾病学家比女性肾病学家更有可能获得研究支付。
