医疗保险支付与白内障摘除率的变化

Medicare payments and changes in the rate of cataract extraction.

作者信息

Taylor J M

出版信息

Ophthalmology. 1981 Jan;88(1):41A-46A.

Abstract

The influence of Medicare payments on cataract extraction was studied. This operation is now the most frequent one performed on Medicare beneficiaries. The rate per 1,000 has more than doubled. The aggregate number of operations has tripled since 1965. As the number of persons over 65 has only increased by 27% in that time and the number of ophthalmologists by 25%, it is evident that each surgeon is doing more cases. Analysis of two representative years of Medicare's payment records indicated that many more surgeons received high payments in 1977 than in 1972. This reflected an increase in fees, but also an increased number of cases. Just over 2% of surgeons received more than $75,000 for cataract surgery on Medicare beneficiaries. The suggested reasons for the findings are an absence of mutually accepted criteria for cataract extraction, Medicare's fee system, and public attitudes.

摘要

研究了医疗保险支付对白内障摘除术的影响。这种手术目前是医疗保险受益人群中最常进行的手术。每千例的手术率增长了一倍多。自1965年以来，手术总数增长了两倍。由于65岁以上的人数在那段时间仅增加了27%，眼科医生人数增加了25%，显然每位外科医生做的病例更多了。对医疗保险支付记录中两个具有代表性年份的分析表明，1977年获得高额支付的外科医生比1972年多得多。这既反映了费用的增加，也反映了病例数量的增加。略超过2%的外科医生因给医疗保险受益人做白内障手术而收入超过75000美元。对这些发现提出的原因是缺乏关于白内障摘除术的公认标准、医疗保险的收费制度以及公众态度。