Abstract：
BACKGROUND: Nail excisions are indicated for onychocryptosis and nail spicules. They are technically demanding and require a refined skill set. We aimed to characterize practice patterns of US providers performing nail excisions.
METHODS: We conducted a retrospective analysis of Medicare provider use and payment data, part D, for all claims of partial or complete nail/nail matrix excision with/without nail plate removal/destruction (current procedural terminology code 11750). High performers were defined as providers performing annual nail excisions 2 standard deviations above the mean. We analyzed demographic risk factors for nail excision high performers, including practice location, years of experience, household median income, practice type, and provider gender. Statistical analysis was conducted in SAS v9.4, with values of P < .05 considered statistically significant.
RESULTS: Providers (n = 32,279) and high performers (n = 942) performed mean 34.7 and 173 nail excisions annually. Unsurprisingly, podiatrists constituted 99.7% of all nail excision performers. Providers in the South versus Midwest and Northeast were more often nail excision high performers (odds ratio [OR], 1.95; P < .0001, and OR, 1.46; P < .0001). Solo versus group practitioners were more likely, respectively, to be nail excision high performers (OR, 2.15; P < .0001). With linear regression analysis, for every 10-year increase in years of provider experience, there was an increase of 1.2 nail excisions annually per provider (P < .0001). For every $100,000 increase in household median income of practice location, there was a decrease of 9.9 nail excisions annually per provider.
CONCLUSIONS: Southern podiatrists, podiatrists with more years of experience, solo practitioners, and those practicing in regions with lower household median incomes were more likely to perform higher numbers of nail excisions. Identifying performance trends among podiatrists can help podiatrists understand how their performance of nail excisions compares to other podiatrists across the country.
METHODS: We conducted a retrospective analysis of Medicare provider use and payment data, part D, for all claims of partial or complete nail/nail matrix excision with/without nail plate removal/destruction (current procedural terminology code 11750). High performers were defined as providers performing annual nail excisions 2 standard deviations above the mean. We analyzed demographic risk factors for nail excision high performers, including practice location, years of experience, household median income, practice type, and provider gender. Statistical analysis was conducted in SAS v9.4, with values of P < .05 considered statistically significant.
RESULTS: Providers (n = 32,279) and high performers (n = 942) performed mean 34.7 and 173 nail excisions annually. Unsurprisingly, podiatrists constituted 99.7% of all nail excision performers. Providers in the South versus Midwest and Northeast were more often nail excision high performers (odds ratio [OR], 1.95; P < .0001, and OR, 1.46; P < .0001). Solo versus group practitioners were more likely, respectively, to be nail excision high performers (OR, 2.15; P < .0001). With linear regression analysis, for every 10-year increase in years of provider experience, there was an increase of 1.2 nail excisions annually per provider (P < .0001). For every $100,000 increase in household median income of practice location, there was a decrease of 9.9 nail excisions annually per provider.
CONCLUSIONS: Southern podiatrists, podiatrists with more years of experience, solo practitioners, and those practicing in regions with lower household median incomes were more likely to perform higher numbers of nail excisions. Identifying performance trends among podiatrists can help podiatrists understand how their performance of nail excisions compares to other podiatrists across the country.
摘要：
背景：指甲切除适用于甲癣和指甲针状突起。他们在技术上要求很高，需要一套精致的技能。我们旨在描述美国供应商进行指甲切除的实践模式。
方法：我们对医疗保险提供者的使用和支付数据进行了回顾性分析，D部分,对于部分或完全的指甲/指甲基质切除有/没有指甲板移除/破坏的所有索赔（当前程序术语代码11750）。高绩效者被定义为每年进行指甲切除的提供者比平均值高出2个标准偏差。我们分析了指甲切除高绩效人群的人口危险因素，包括练习地点，多年的经验,家庭收入中位数，实践类型,和提供者的性别。在SASv9.4中进行统计学分析，P<0.05的值被认为具有统计学意义。
结果：提供者（n=32,279）和高绩效者（n=942）每年平均进行34.7和173次指甲切除。毫不奇怪,足病医生占所有指甲切除者的99.7％。南部、中西部和东北部的供应商更经常是指甲切除高绩效者(赔率比[OR]，1.95;P<.0001,OR,1.46；P<.0001）。独奏与团体从业者的可能性更大，分别,做指甲切除的表演者(或者，2.15;P<.0001)。通过线性回归分析，提供商经验每增加10年，每个提供者每年增加1.2例指甲切除(P<0.0001).执业地点的家庭收入中位数每增加100,000美元，每个提供者每年减少9.9例指甲切除.
结论：南方足病医生，有多年经验的足病医生，独奏从业者，那些在家庭收入中位数较低的地区执业的人更有可能进行更多的指甲切除术。确定足病医生的表现趋势可以帮助足病医生了解他们的指甲切除表现与全国其他足病医生相比如何。
方法：我们对医疗保险提供者的使用和支付数据进行了回顾性分析，D部分,对于部分或完全的指甲/指甲基质切除有/没有指甲板移除/破坏的所有索赔（当前程序术语代码11750）。高绩效者被定义为每年进行指甲切除的提供者比平均值高出2个标准偏差。我们分析了指甲切除高绩效人群的人口危险因素，包括练习地点，多年的经验,家庭收入中位数，实践类型,和提供者的性别。在SASv9.4中进行统计学分析，P<0.05的值被认为具有统计学意义。
结果：提供者（n=32,279）和高绩效者（n=942）每年平均进行34.7和173次指甲切除。毫不奇怪,足病医生占所有指甲切除者的99.7％。南部、中西部和东北部的供应商更经常是指甲切除高绩效者(赔率比[OR]，1.95;P<.0001,OR,1.46；P<.0001）。独奏与团体从业者的可能性更大，分别,做指甲切除的表演者(或者，2.15;P<.0001)。通过线性回归分析，提供商经验每增加10年，每个提供者每年增加1.2例指甲切除(P<0.0001).执业地点的家庭收入中位数每增加100,000美元，每个提供者每年减少9.9例指甲切除.
结论：南方足病医生，有多年经验的足病医生，独奏从业者，那些在家庭收入中位数较低的地区执业的人更有可能进行更多的指甲切除术。确定足病医生的表现趋势可以帮助足病医生了解他们的指甲切除表现与全国其他足病医生相比如何。
