价格与偏见:男性与女性解剖手术的报销。

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Madeline Penn, Donessa Colley, Pratistha Koirala, Louise King, Jocelyn Fitzgerald
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引用次数: 0

摘要

背景:性别偏见是卫生保健中普遍存在的问题,导致妇女的健康结果比男子差。在美国,研究表明,针对特定性别的手术的相对价值单位(RVUs)存在缓慢改善,但持续存在差异。本研究旨在以现有文献为基础,对可比较的针对性别的外科手术进行大规模分析,以确定在向女性患者提供的rvu /医疗报销方面是否仍然存在差异。方法:使用110个CPT代码,我们比较了2023年数据集中解剖学上相似的性别特异性手术的设施和非设施手术的工作RVU和报销率,并由一组妇科医生和泌尿科医生验证。我们分析了2003年至2023年期间rvu的20年期间的程序,以确定性别特定程序之间的差异如何随时间变化。我们还使用与Goff(1997)和Benoit(2015)相同的设计和22个现行程序术语(CPT)代码来比较1997年、2015年和2023年的rvu。结果:在55例性别特异性手术中,41例(75%)在2023年女性患者手术的rvu较低。男性患者手术的rvu平均高出30%。在医疗机构报销方面,35家(64%)医院对男性患者的报销较高,平均高出25.6%,与男性患者的平均报销多75.73美元相关。对于非设施报销,男性手术的报销平均高出20%。2003年至2023年间,男性与女性手术的报销差异没有统计学上的显著改善,男性手术的平均RVU始终比女性高31-34%。在1997年、2015年和2023年期间,这一差距略有缩小。结论:在针对不同性别的手术之间仍然存在显著差异,女性患者的rvu /报销较低,在过去三十年中变化很小。解决这些差异对于实现保健领域的性别平等和确保同等重视医疗服务至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Price and Prejudice: Reimbursement of Surgical Care on Male Versus Female Anatomies.

Background: Gender bias is a pervasive issue in health care, contributing to poorer health outcomes for women compared with men. In the United States, studies have shown a slowly improving, but persistent, disparity exists for gender-specific procedures' relative value units (RVUs). This study aims to build on existing literature and conduct a large-scale analysis examining comparable gender-specific surgical procedures to determine whether there remains a disparity in RVUs/reimbursements for care provided to female patients. Methods: Using 110 CPT codes, we compared work RVU and reimbursement rates for facility and nonfacility procedures within the 2023 dataset for anatomically similar gender-specific procedures, verified by a group of gynecologists and urologists. We analyzed the procedures over a 20-year period with RVUs from 2003 to 2023 to determine how the difference between the gender-specific procedures was changing over time. We also used the same design and 22 current procedural terminology (CPT) codes as Goff (1997) and Benoit (2015) to compare RVUs between 1997, 2015, and 2023. Results: For the 55 gender-specific procedures, 41 (75%) had lower RVUs for procedures on female patients in 2023. RVUs for procedures on male patients were 30% higher on average. For facility reimbursement, 35 (64%) were higher for procedures on male patients-with a 25.6% higher reimbursement on average, correlating to an average reimbursement of $75.73 more for male procedures. For nonfacility reimbursements, male procedures were reimbursed 20% higher on average. Between 2003 and 2023, there were no statistically significant improvements in the reimbursement disparities for male versus female procedures, with male procedures consistently having an average RVU 31-34% higher. The disparity narrowed minimally between 1997, 2015, and 2023. Conclusion: There remain significant disparities between gender-specific procedures, with lower RVUs/reimbursements for procedures on female patients and minimal change over the past three decades. Addressing these disparities is crucial for achieving gender equity in health care and ensuring equally valued medical services.

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来源期刊
Journal of women's health
Journal of women's health 医学-妇产科学
CiteScore
6.60
自引率
5.70%
发文量
197
审稿时长
2 months
期刊介绍: Journal of Women''s Health is the primary source of information for meeting the challenges of providing optimal health care for women throughout their lifespan. The Journal delivers cutting-edge advancements in diagnostic procedures, therapeutic protocols for the management of diseases, and innovative research in gender-based biology that impacts patient care and treatment. Journal of Women’s Health coverage includes: -Internal Medicine Endocrinology- Cardiology- Oncology- Obstetrics/Gynecology- Urogynecology- Psychiatry- Neurology- Nutrition- Sex-Based Biology- Complementary Medicine- Sports Medicine- Surgery- Medical Education- Public Policy.
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