公共整形外科手术报销和利用率下降,2016年至2024年
1From the Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD.
The Journal of the American Academy of Orthopaedic Surgeons
|January 29, 2025
概括
医疗保险对整形外科手术的补偿大幅下降,导致患者的访问和利用减少,特别是在流行后. 评估和管理服务的下降幅度较小,利用率稳定.
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
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗保险的报销率会影响弱势患者获得骨科手术的机会.
- 肌肉骨损伤不成比例地影响到医疗保险人口.
- 退款减少可能会限制受益人的手术选择.
研究的目的:
- 分析医疗保险补偿和用于骨科手术的使用趋势.
- 将这些趋势与评估和管理 (E/M) 服务进行比较.
- 评估报销变化对外科手术接入的影响.
主要方法:
- 使用的医疗保险和医疗补助服务中心医生费用表数据 (2016-2024年).
- 分析了医疗保险B部分使用数据 (2016-2022年).
- 使用线性回归和Wilcoxon签名等级测试进行趋势和显著性分析.
主要成果:
- 整形外科手术补偿金从2016年至2024年减少了26.2% (1558美元至1150美元) (P < 0.0001).
- 从2016年到2022年,整形外科手术的利用率大幅下降 (P < 0.0001).
- 在使用率稳定的情况下,E/M服务报销下降了15.82% (P = 0.9102).
结论:
- 医疗保险报销的持续下降与骨科手术利用率的减少有关.
- 随着COVID-19的流行,利用率下降的情况更加恶化.
- 报销率似乎影响了骨科手术的可及性和使用率.
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