Clinical Productivity and Patient Complexity of Academic Rhinologists: An Analysis of Medicare Metrics.

Autor: Warn MJ; School of Medicine, University of California, Riverside, California, U.S.A., Torabi SJ; Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, California, U.S.A., Bitner BF; Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, California, U.S.A., Chan D; Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, California, U.S.A., Nguyen TV; Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, California, U.S.A., Kuan EC; Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, California, U.S.A.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2024 Sep; Vol. 134 (9), pp. 3960-3964. Date of Electronic Publication: 2024 Apr 10.
DOI: 10.1002/lary.31437
Abstrakt: Introduction: Current data regarding reimbursement trends in Medicare services and the complexity of patients treated as physicians' progress in their academic career are conflicting. In otolaryngology, there are no data examining these metrics.
Methods: Medicare services, reimbursement, and patient complexity risk scores (based on hierarchical condition category coding) of US rhinology fellowship-trained faculty were stratified and compared by rank and years in practice.
Results: A cohort of 209 rhinologists were included. Full professors were reimbursed more per service than assistant professors ($791.53 [$491.69-1052.46] vs. $590.34 [$429.91-853.07] p = 0.045) and had lower risk scores (1.37 [1.26-1.52] vs. 1.49 [1.29-1.68], p = 0.013). Full professors had similar risk scores to associate professors (1.47 [1.25-1.64], p = 0.14). Full professors ($791.53 [$491.69-1,052.46], p < 0.001), associate professors ($706.85 [$473.48-941.15], p < 0.001), and assistant professors ($590.34 [$429.91-853.07], p < 0.001) were all reimbursed more per service than non-ranked faculty ($326.08 [$223.37-482.36]). As a cohort, significant declines in risk scores occurred within the 10th-14th year of practice (p = 0.032) and after the 20th year (p = 0.038). Years in practice were inversely correlated with risk score (R = -0.358, p < 0.001).
Conclusion: Full professors were reimbursed more per service and treated less comorbid Medicare patients than junior academic colleagues. Patient comorbidity was correlated negatively with years in practice, with significant drops in mid and late career. Rhinologists employed at academic institutions had greater total reimbursement and reimbursement per service than non-ranked faculty.
Level of Evidence: N/A Laryngoscope, 134:3960-3964, 2024.
(© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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