Evidence map›Paper›PMID 35588946›Full record

ArticleOphthalmology2022

Sex-Based Differences in Medicare Reimbursements among Ophthalmologists Persist across Time.

Omar Alaa Halawa, Sayuri Sekimitsu, Michael V Boland, Nazlee Zebardast

Open access · greenAbstract read
In one paragraph

Article in Ophthalmology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
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

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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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 at 2 institutions in 1 country.

Omar Alaa HalawaDepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Sayuri SekimitsuDepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts.
Michael V BolandDepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Nazlee ZebardastDepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: nazlee_zebardast@meei.harvard.edu.
Massachusetts Eye and Ear Infirmary · USTufts University · US

Funding

Glaucoma Risk Prediction Using Machine Learning Integration of Image-Based Phenotypes and Genetic AssociationsK23EY032634 · NEI · MASSACHUSETTS EYE AND EAR INFIRMARY · PI ZEBARDAST, NAZLEE · 2021 to 2024
$1.0M
Sociodemographic predictors of healthcare utilization and adverse outcomes in Medicare beneficiaries with glaucomaR21EY032953 · NEI · MASSACHUSETTS EYE AND EAR INFIRMARY · PI ZEBARDAST, NAZLEE · 2021 to 2022
$493k
NEI NIH HHS K23 EY032634NEI NIH HHS R21 EY032953
6 · The paper itself

Abstract

purposeTo evaluate differences in Medicare reimbursements between male and female ophthalmologists between 2013 and 2019.

designRetrospective cohort study.

participantsOphthalmologists receiving Medicare reimbursements between 2013 and 2019.

methodsThe Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File was used to determine total reimbursements and number of services submitted by ophthalmologists between 2013 and 2019. Reimbursements were standardized to account for geographic differences in Medicare reimbursement per service. Data from the American Community Survey (ACS) were used to determine socioeconomic characteristics (unemployment, poverty, income, and education) by zip code for the location of each physician's practice. A multivariate linear regression model was used to evaluate differences in annual reimbursements by sex, accounting for calendar year, years of experience, total number of services, ACS zip code data, and proportion of procedural services.

main outcome measuresAnnual Medicare reimbursement and use of billing codes (e.g., outpatient office visits and eye examinations, diagnostic testing, laser treatment, and surgery).

resultsAmong 20 281 ophthalmologists who received Medicare reimbursements between 2013 and 2019, 15 451 (76%) were men. The most common billing codes submitted were for outpatient visits and eye examinations (13.8 million charges/year), diagnostic imaging of the retina (5.6 million charges/year), intravitreal injections (2.9 million charges/year), and removal of cataract with insertion of lens (2.4 million charges/year). Compared with men, female ophthalmologists received less in median annual reimbursements (median, $94 734.21 [interquartile range (IQR), $30 944.52-$195 701.70] for women vs. $194 176.90 [IQR, $76 380.76-$355 790.80] for men; P < 0.001) and billed for fewer annual median services (median, 1228 [IQR, 454-2433] vs. 2259 [IQR, 996-4075, respectively]; P < 0.001). After adjustment for covariates, female ophthalmologists billed for 1015 fewer services (95% confidence interval [CI], 1001-1029; P < 0.001) and received $20 209.12 less in reimbursements than men (95% CI, -$21 717.57 to -$18 700.66; P < 0.001).

conclusionsFemale ophthalmologists billed for fewer services and received less in reimbursement from Medicare than men over time and across all categories of billing codes. Disparities persisted after controlling for physician and practice characteristics.

Indexed as

OphthalmologistsAgedCenters for Medicare and Medicaid Services, U.S.FemaleHumansIntravitreal InjectionsMaleMedicareRetrospective StudiesUnited StatesCMSDisparitiesFemale ophthalmologistsMedicareReimbursements

Identifiers

PMID35588946
PMCPMC9730864
OpenAlexW4280652779

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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.