Abstract：
BACKGROUND: In the United States (US) men who undergo vasectomy and/or vasectomy reversal (vasovasotomy) are likely to pay out-of-pocket for these procedures. We characterized the publicly disclosed pricing of both procedures with a focus on variability in self-pay prices.
METHODS: We queried all US hospitals for publicly disclosed prices of vasectomy and vasovasotomy. We assessed interhospital variability in self-pay pricing and compared hospitals charging high (≥75th percentile) and low (≤25th percentile) self-pay prices for either procedure. We also examined trends in pricing after the 2022 US Supreme Court decision that allowed individual states to ban abortion.
RESULTS: Of 6692 hospitals, 1375 (20.5%) and 281 (4.2%) disclosed self-pay prices for vasectomy and vasovasotomy, respectively. There was a 17-fold difference between the 10th and 90th percentile self-pay prices for vasectomy ($421-$7147) and a 39-fold difference for vasovasotomy ($446-$17,249). Compared with hospitals charging low (≤25th percentile) self-pay prices for vasectomy or vasovasotomy, hospitals charging high (≥75th percentile) prices were larger (median 150 vs. 59 beds, p < 0.001) and more likely to be for-profit (31.2% vs. 7.8%, p < 0.001), academic-affiliated (52.7% vs. 23.1%, p < 0.001), and located in an urban zip code (70.1% vs. 41.3%, p < 0.001). From October 2022 to April 2023, the median self-pay price of vasectomy increased by 10% (from $1667 to $1832) while the median self-pay price of vasovasotomy decreased by 16% (from $3309 to $2786).
CONCLUSIONS: We found large variability in self-pay pricing for vasectomy and vasectomy reversal, which may serve as a barrier to the accessibility of male reproductive care.
METHODS: We queried all US hospitals for publicly disclosed prices of vasectomy and vasovasotomy. We assessed interhospital variability in self-pay pricing and compared hospitals charging high (≥75th percentile) and low (≤25th percentile) self-pay prices for either procedure. We also examined trends in pricing after the 2022 US Supreme Court decision that allowed individual states to ban abortion.
RESULTS: Of 6692 hospitals, 1375 (20.5%) and 281 (4.2%) disclosed self-pay prices for vasectomy and vasovasotomy, respectively. There was a 17-fold difference between the 10th and 90th percentile self-pay prices for vasectomy ($421-$7147) and a 39-fold difference for vasovasotomy ($446-$17,249). Compared with hospitals charging low (≤25th percentile) self-pay prices for vasectomy or vasovasotomy, hospitals charging high (≥75th percentile) prices were larger (median 150 vs. 59 beds, p < 0.001) and more likely to be for-profit (31.2% vs. 7.8%, p < 0.001), academic-affiliated (52.7% vs. 23.1%, p < 0.001), and located in an urban zip code (70.1% vs. 41.3%, p < 0.001). From October 2022 to April 2023, the median self-pay price of vasectomy increased by 10% (from $1667 to $1832) while the median self-pay price of vasovasotomy decreased by 16% (from $3309 to $2786).
CONCLUSIONS: We found large variability in self-pay pricing for vasectomy and vasectomy reversal, which may serve as a barrier to the accessibility of male reproductive care.
摘要：
背景：在美国（US），接受输精管结扎术和/或输精管结扎术逆转（血管切开术）的男性可能会为这些手术自费。我们以公开披露的两种程序的定价为特征，重点是自付价格的可变性。
方法：我们询问了所有美国医院公开披露的输精管切除术和血管切开术的价格。我们评估了医院间自费定价的差异，并比较了两种程序收取高（≥第75百分位数）和低（≤第25百分位数）自费价格的医院。我们还研究了2022年美国最高法院允许各州禁止堕胎的决定后的价格趋势。
结果：在6692家医院中，1375（20.5%）和281（4.2%）披露了输精管结扎术和血管切开术的自付价格，分别。输精管切除术的第10百分位数和第90百分位数的自付价格之间存在17倍的差异（$421-$7147），而血管切开术的差异为39倍（$446-$17,249）。与医院收取低（≤25百分位数）的输精管结扎术或血管切开术的自付价格相比，医院收费高(≥第75百分位数)价格较大(中位数150vs.59张床,p<0.001)，更有可能是营利性的(31.2%与7.8%,p<0.001)，学术附属(52.7%与23.1%,p<0.001)，并位于城市邮政编码(70.1%与41.3%,p<0.001)。从2022年10月到2023年4月，输精管切除术的自付价格中位数增加了10％（从1667美元增加到1832美元），而血管切开术的自付价格中位数减少了16％（从3309美元减少到2786美元）。
结论：我们发现输精管结扎和输精管结扎逆转的自费定价差异很大，这可能是男性生殖保健获得的障碍。
方法：我们询问了所有美国医院公开披露的输精管切除术和血管切开术的价格。我们评估了医院间自费定价的差异，并比较了两种程序收取高（≥第75百分位数）和低（≤第25百分位数）自费价格的医院。我们还研究了2022年美国最高法院允许各州禁止堕胎的决定后的价格趋势。
结果：在6692家医院中，1375（20.5%）和281（4.2%）披露了输精管结扎术和血管切开术的自付价格，分别。输精管切除术的第10百分位数和第90百分位数的自付价格之间存在17倍的差异（$421-$7147），而血管切开术的差异为39倍（$446-$17,249）。与医院收取低（≤25百分位数）的输精管结扎术或血管切开术的自付价格相比，医院收费高(≥第75百分位数)价格较大(中位数150vs.59张床,p<0.001)，更有可能是营利性的(31.2%与7.8%,p<0.001)，学术附属(52.7%与23.1%,p<0.001)，并位于城市邮政编码(70.1%与41.3%,p<0.001)。从2022年10月到2023年4月，输精管切除术的自付价格中位数增加了10％（从1667美元增加到1832美元），而血管切开术的自付价格中位数减少了16％（从3309美元减少到2786美元）。
结论：我们发现输精管结扎和输精管结扎逆转的自费定价差异很大，这可能是男性生殖保健获得的障碍。
