PDF(Pubmed)
Abstract：
Introduction The authors examined if the transparency in industry payments to foot and ankle-trained orthopedic surgeons resulted in the following changes to the (1) median general payments to surgeons, (2) trend in median payments to surgeons across all subcategory payments, and (3) trend in median payments to surgeons in 11 regions of the United States. Methods A retrospective review of the Centers for Medicare and Medicaid Services (CMS) and Open Payments Database (OPD) was performed to identify all industry payments made by drug and medical device companies to orthopedic surgeons (N = 3,835) between January 1, 2014, and December 31, 2019. Descriptive statistics were calculated, and trend analyses in annual payments, number of payments to surgeons per year, payment subtypes, and regional distributions were analyzed. Results A total of 53,280 payments totaling $53,454,850.56 were made to orthopedic foot and ankle surgeons between 2014 and 2019. Mean and median payments were $1,003.28 and $60.19, respectively. Statistically significant differences in mean payment amounts were observed by year (p = 0.001) with a highly statistically significant, strong increase in the number of payments made over the six-year period (r = 0.97, p < 0.001). The greatest increases in median individual payments were observed for gifts (277.1%; r = 0.18, p = 0.05), education (250.6%; r = 0.17, p < 0.001), and royalties and licensing (72.1%; r = 0.05, p = 0.04). Statistically significant increasing trends in median payments over time were observed for the Northeast (p < 0.001) and South regions (p < 0.001). Discussion The results of this study demonstrate the increase in payments made across the six-year time period. The study demonstrates that there is a shift in the type of payments from speaker fees, entertainment, and lodging to education, gifts, honoraria, royalties, and consulting. Conclusion Since the OPD release, no significant decrease was identified in the financial relationship between foot and ankle surgeons and the industry; rather, an increase was observed. This increase in education, royalties, and consulting shows that more foot and ankle surgeons are getting involved in the industry, contrary to expectations. The partnership between industry and physicians can help to improve innovation and bring new ideas to the future of orthopedics.
摘要：
介绍作者研究了行业支付给足踝部受过训练的骨科医生的透明度是否导致以下变化（1）对外科医生的一般支付中位数，(2)所有子类别支付给外科医生的支付中位数趋势，(3)美国11个地区向外科医生支付的中位数趋势。方法对医疗保险和医疗补助服务中心(CMS)和开放支付数据库(OPD)进行回顾性审查，以确定药品和医疗器械公司在2014年1月1日至2019年12月31日期间向整形外科医生支付的所有行业支付(N=3,835)。计算了描述性统计数据，以及年度付款趋势分析，每年向外科医生付款的数量，支付子类型，并对区域分布进行了分析。结果在2014年至2019年期间，总共向骨科足踝外科医生支付了53,280笔款项，总计53,454,850.56美元。平均和中位数付款分别为1,003.28美元和60.19美元。按年度观察到平均付款金额的统计显着差异（p=0.001），具有高度统计学意义，六年期间付款数量大幅增加(r=0.97，p<0.001)。礼品的个人付款中位数增长最大（277.1％；r=0.18，p=0.05），教育(250.6%；r=0.17，p<0.001)，以及特许权使用费和许可（72.1%；r=0.05，p=0.04）。在东北部（p<0.001）和南部地区（p<0.001），随着时间的推移，中位数付款的增长趋势具有统计学意义。讨论这项研究的结果表明，在六年的时间内，支付的款项有所增加。这项研究表明，从演讲者费用的支付类型发生了转变，娱乐,接受教育，礼物,酬金,特许权使用费,和咨询。结论自OPD发布以来，足踝外科医生与行业之间的财务关系没有显着下降；相反，观察到增加。这种教育的增加，特许权使用费,咨询表明，越来越多的足踝外科医生开始涉足这个行业，与预期相反。行业和医生之间的合作可以帮助改善创新，并为骨科的未来带来新的想法。
