The provision of sterilization services by private physicians.

Area of Science:

• Medical Practice Patterns
• Surgical Procedures

Background:

• Female sterilizations are primarily performed by obstetrician-gynecologists, while urologists are the main providers of vasectomies.
• Physician specialty significantly influences the likelihood of performing these procedures compared to general surgeons or practitioners.

Purpose of the Study:

• To analyze physician demographics and practice characteristics associated with performing male and female sterilizations.
• To compare the settings and costs of female sterilization and vasectomy procedures.
• To assess physician acceptance of Medicaid and fee reductions for sterilization procedures.

Main Methods:

• Analysis of physician practice patterns, procedure volumes, and patient demographics.
• Comparison of sterilization procedure settings (inpatient, outpatient, office-based).
• Evaluation of procedure costs and physician acceptance of insurance and fee adjustments.

Main Results:

• Obstetrician-gynecologists and urologists perform sterilizations more frequently than generalists. Group practices and North Central region locations correlate with higher volumes.
• Female sterilizations are predominantly inpatient or hospital outpatient; vasectomies are mostly office-based. Inpatient vasectomies may involve general anesthesia or concurrent surgeries.
• Average costs in 1982: inpatient female sterilization $1,335, outpatient sterilization slightly less, vasectomy $240 (office) to $511 (inpatient). Specialist fees are higher. Over half of physicians accept Medicaid, with 12% reducing fees.

Conclusions:

• Physician specialty, practice setting, and geographic region impact sterilization procedure rates and volume.
• Significant differences exist in the settings and associated costs for male versus female sterilization.
• Physician participation in Medicaid and willingness to adjust fees are crucial for patient access to sterilization services.