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远距离半径固定补偿,收费和利用在医疗保险人口中的趋势

Suresh K Nayar^1,2,3, Aoife MacMahon¹, Heath P Gould^2,3

¹Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland, United States.

Journal of hand and microsurgery

|September 13, 2023

概括

从2012年到2017年,医生支付远端半径骨折手术的费用比通货膨胀更快,除了封闭缩减皮穿刺 (CRPP) 之外. 患者费用超过了外科医生的支付,CRPP手术显著下降.

科学领域:

整形外科手术整形外科手术
卫生经济学卫生经济学
老年医学老年医学

背景情况:

远距离半径骨折 (DRF) 在老年人中很常见,代表了相当大的医疗保健成本.
对DRF的手术管理对上肢手术的医疗保险支出做出了重大贡献.

研究的目的:

分析2012年至2017年间手术治疗,医生支付和DRF固定患者费用的时间趋势.
评估对常见的DRF外科手术手术的报销比率的变化.

主要方法:

对2012-2017年4次DRF手术的Medicare数据进行了回顾性分析:CRPP,ORIF外关节手术,ORIF IA (2片段) 和ORIF IA (>3片段).
通过消费者价格指数对通货膨胀进行调整,检查了手术量,患者费用和外科医生费用.
用费用与付款的比率来计算退款比率.

主要成果:

对于DRF手术的患者总费用增加了64%,而外科医生支付增加了42%.
封闭缩减皮穿刺 (CRPP) 病例减少了47%,而各种开放缩减内部固定 (ORIF) 程序增加了.
对通货膨胀调整后的医生支付在所有ORIF类型中增加,但在CRPP中下降;费用始终超过支付,导致退还率下降.

结论:

医生支付远半径ORIF,不包括CRPP,超过了2012-2017年的通货膨胀,尽管患者费用增长速度快于支付.
在研究期间观察到CRPP程序的显著下降.
经济趋势表明,外科手术管理和远半径骨折的补偿发生了变化.

关键词:

封闭的减少通过皮肤固定固定.偏半径骨折偏半径骨折偏半径骨折偏半径骨折患者收取费用,患者收取费用.外科医生支付的付款飞行板是飞行板.

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