Characteristics and Practice Patterns of Non-certified Surgeons Treating Medicare Patients.

Autor:	Moreci R; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI., Gates RS; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI., Luckoski J; Department of Surgery, University of Toledo, Toledo, OH., Marcotte K; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI.; Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI., Mullens CL; Department of Surgery, University of Michigan, Ann Arbor, MI., Yee CC; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI., Gupta T; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI., Kendrick D; Department of Surgery, University of Minnesota, Minneapolis, MN., Thelen A; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI., Krumm AE; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI.; Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI., George BC; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, MI.; Department of Surgery, University of Michigan, Ann Arbor, MI.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2024 Apr 12. Date of Electronic Publication: 2024 Apr 12.
DOI:	10.1097/SLA.0000000000006298
Abstrakt:	Objective: The objective of this study is to explore the patient characteristics and practice patterns of non-certified surgeons who treat Medicare patients in the United States. Summary Background Data: While most surgeons in the United States are board-certified, non-certified surgeons are permitted to practice in many locations. At the same time, surgical workforce shortages threaten access to surgical care for many patients. It is possible that non-certified surgeons may be able to help fill these access gaps. However, little is known about the practice patterns of non-certified surgeons. Methods: A 100% sample of Medicare claims data from 2014-2019 were used to identify practicing general surgeons. Surgeons were categorized as certified or non-certified in general surgery​​ based on data from the American Board of Surgery. Surgeon practice patterns and patient characteristics were analyzed. Results: A total of 2,097,206 patient cases were included in the study. These patients were treated by 16,076 surgeons, of which 6% were identified as non-certified surgeons. Compared to certified surgeons, non-certified surgeons were less frequently fellowship-trained (20.5% vs. 24.2%, P=0.008) and more likely to be a foreign medical graduate (14.5% vs. 9.2%, P<0.001). Non-certified surgeons were more frequently practicing in for-profit hospitals (21.2% vs. 14.2%, P<0.001) and critical access hospitals (2.2% vs. 1.3%, P<0.001), and were less likely to practice in a teaching hospital (63.2% vs. 72.4%, P<0.001). Compared to certified surgeons, non-certified surgeons treated more non-White patients (19.6% vs. 14%, P<0.001) as well as a higher percentage of patients in the two lowest socioeconomic status (SES) quintiles (36.2% vs. 29.2%, P<0.001). Operations related to emergency admissions were more common amongst non-certified surgeons (68.8% vs. 55.7%, P<0.001). There were no differences in gender or age of the patients treated by certified and non-certified surgeons. Conclusion: For Medicare patients, non-certified surgeons treated more patients who are non-White, of lower SES, and in more rural, critical-access hospitals. Competing Interests: Conflicts of Interest and Sources of Funding: None declared. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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