How Variable are Patient Comorbidity Profiles Among Practicing Otolaryngologists?

Area of Science:

• Otolaryngology
• Health Services Research
• Health Equity

Background:

• Physician practice patterns can influence patient outcomes and healthcare costs.
• Understanding comorbidity distribution among otolaryngologists (ORLs) is crucial for resource allocation and equitable care.
• The Hierarchical Condition Category (HCC) risk score serves as a validated measure of patient comorbidity burden.

Purpose of the Study:

• To investigate variations in patient comorbidity profiles among otolaryngologists (ORLs).
• To identify physician characteristics associated with treating patients with higher comorbidity burdens.
• To explore potential implications for health equity in otolaryngology practice.

Main Methods:

• A cross-sectional, population-based analysis using the 2019 Medicare Provider Utilization and Payment Dataset.
• Calculated average HCC risk scores for Medicare patients treated by each ORL.
• Stratified and compared HCC scores based on physician characteristics: practice region, rurality, years in practice, gender, subspecialty, and practice setting (academic vs. community).

Main Results:

• The mean HCC risk score among 8959 ORLs was 1.35 ± 0.35.
• ORLs in urban settings, academic practices, and early in their careers had significantly higher patient HCC risk scores (P < .001).
• Multivariate analysis confirmed that rural practice setting (OR: 0.58) and community setting (OR: 0.36) were associated with lower odds of high-risk patients, while recent graduation (2000-2015) was linked to increased odds.

Conclusions:

• Significant variability exists in patient comorbidity profiles among otolaryngologists.
• Physicians in urban, academic settings, and those more recently graduated manage patients with higher comorbidity burdens.
• These practice variations have potential implications for healthcare costs, clinical outcomes, and health equity within otolaryngology.