Evidence map›Paper›PMID 27859299›Full record

ArticleThe Laryngoscope2017

Predictors of regional Medicare expenditures for otolaryngology physician services.

Alden Smith, Elizabeth Handorf, Ellis Arjmand, Miriam N Lango

Abstract read
In one paragraph

Article in The Laryngoscope, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Alden SmithLewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
Elizabeth HandorfBiostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Houston, Texas.
Ellis ArjmandDepartment of Surgery (Otolaryngology), Texas Children's Hospital, Houston, Texas.
Miriam N LangoDepartment of Surgical Oncology, Head and Neck Surgery Section, Fox Chase Cancer Center; and the Department of Otolaryngology, Temple University School of Medicine Philadelphia, Pennsylvania.

Funding

WORD PROCESSING CENTER--COREP30CA006927 · NCI · RESEARCH INST OF FOX CHASE CAN CTR · PI CHARNITA M. ZEIGLER-JOHNSON · 1985 to 2026
$138.8M
NCI NIH HHS P30 CA006927
6 · The paper itself

Abstract

objectiveTo describe geographic variation in spending and evaluate regional Medicare expenditures for otolaryngologist services with population- and beneficiary-related factors, physician supply, and hospital system factors. STUDY

designCross-sectional study.

methodsThe average regional expenditures for otolaryngology physician services were defined as the total work relative value units (wRVUs) collected by otolaryngologists in a hospital referral region (HRR) per thousand Medicare beneficiaries in the HRR. A multivariable linear regression model tested associations with regional sociodemographics (age, sex, race, income, education), the physician and hospital bed supply, and the presence of an otolaryngology residency program.

resultsIn 2012, the mean Medicare expenditure for otolaryngology provider services across HRRs was 224 wRVUs per thousand Medicare beneficiaries (standard deviation [SD] 104), ranging from 31 to 604 wRVUs per thousand Medicare beneficiaries. In 2013, the average Medicare expenditures for each HRR was highly correlated with expenditures collected in 2012 (Pearson correlation coefficient .997, P = .0001). Regional Medicare expenditures were independently and positively associated with otolaryngology, medical specialist, and hospital bed supply in the region, and were negatively associated with the supply of primary care physicians and presence of an otolaryngology residency program after adjusting for other factors. The magnitude of associations with physician supply and hospital factors was stronger than any population or Medicare beneficiary factor.

conclusionWide variations in regional Medicare expenditures for otolaryngology physician services, highly stable over 2 years, were strongly associated with regional health system factors. Changes in health policy for otolaryngology care may require coordination with other physician specialties and integrated hospital systems. LEVEL OF EVIDENCE: NA. Laryngoscope, 127:1312-1317, 2017.

Indexed as

AgedCross-Sectional StudiesFemaleHealth ExpendituresHealth ServicesHospital Bed CapacityHumansInternship and ResidencyLinear ModelsMaleMedicareMultivariate AnalysisOtolaryngologyPractice Patterns, Physicians'Socioeconomic FactorsUnited Statesgeographic variationMedicare expendituresotolaryngology physician

Identifiers

PMID27859299
PMCPMC7682638

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.