Orr M T, Forrest J D, Johnson J H, Tolman D L
Fam Plann Perspect. 1985 Sep-Oct;17(5):216-20.
Obstetrician-gynecologists are 4-5 times more likely to perform female sterilizations, and urologists are 2-3 times more likely to perform vasectomies, than are general surgeons or general or family practitioners. Catholics are less likely to perform either procedure than are non-Catholics. Participation in a group practice and having a practice in the North Central region of the country are associated with carrying out a larger average number of both male and female sterilizations. More than half of female sterilizations are performed as inpatient hospital procedures, and most of the remainder are done in hospitals on an outpatient basis. Two-thirds of vasectomies, on the other hand, are performed in doctors' offices, while most of the rest are performed as hospital outpatient procedures. About one vasectomy in 12, however, is performed on an inpatient basis--possibly because general anesthesia is used, or the procedure is performed along with other surgery. The average cost for an inpatient female sterilization in 1982 was $1,335. The cost for a hospital outpatient sterilization was not much less than that. The total cost of a vasectomy ranged from an average of $511 for an inpatient procedure to $240 for one performed in the office. The average cost is higher when the sterilization is performed by an obstetrician-gynecologist or a urologist than when the service is provided by a general surgeon or general/family practitioner. Fifty-eight percent of physicians performing female sterilizations accept Medicaid reimbursement, and 12 percent reduce their fees to accommodate low-income patients. The proportions for doctors who perform vasectomies are 51 percent and 12 percent.(ABSTRACT TRUNCATED AT 250 WORDS)
与普通外科医生、普通医生或家庭医生相比,妇产科医生实施女性绝育手术的可能性要高4至5倍,泌尿科医生实施输精管切除术的可能性要高2至3倍。天主教徒实施这两种手术的可能性均低于非天主教徒。在团体诊所工作以及在美国中北部地区执业,与实施较大平均数量的男性和女性绝育手术相关。超过一半的女性绝育手术是作为住院医院程序进行的,其余大部分是在医院门诊进行的。另一方面,三分之二的输精管切除术在医生办公室进行,其余大部分作为医院门诊程序进行。然而,每12例输精管切除术中约有1例是在住院基础上进行的——可能是因为使用了全身麻醉,或者该手术与其他手术同时进行。1982年住院女性绝育手术的平均费用为1335美元。医院门诊绝育手术的费用与此相差不大。输精管切除术的总费用从住院手术的平均511美元到在办公室进行的手术的240美元不等。由妇产科医生或泌尿科医生实施绝育手术时的平均费用高于由普通外科医生或普通/家庭医生提供服务时的费用。实施女性绝育手术的医生中有58%接受医疗补助报销,12%降低收费以照顾低收入患者。实施输精管切除术的医生的相应比例分别为51%和12%。(摘要截选至250词)