2015-2023年按提供者类型划分的医疗保险B部分按服务收费计费的诊断性柔性喉镜检查和视频喉频闪检查趋势
Trends in Medicare Part B Fee-for-Service Billing of Diagnostic Flexible Laryngoscopy and Videolaryngostroboscopy by Provider Type, 2015-2023.
文献信息
| PMID | 42760218 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Chulwoo J Kim |
| 作者单位 | Emory University School of Medicine, 100 Woodruff Circle, Atlanta, Georgia 30322. Electronic address: chulwoo.kim@emory.edu. |
| 期刊 | Journal of voice : official journal of the Voice Foundation |
| SCI 分区 | Q1 |
| IF | 2.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 本研究旨在评估2015-2023年医生和高级实践提供者（APP）使用诊断性柔性喉镜检查（DFL）和视频喉频闪检查（VLS）的全国趋势及2023年州级差异。
方法： 这是一项对2015年至2023年医疗保险B部分按服务收费数据的重复横断面分析，数据收集自医疗保险提供者使用与支付数据：医生及其他从业者公共使用文件以及美国医疗保险和医疗补助服务中心发布的医疗保险月度参保数据。计算了复合年增长率（CAGR）以及线性和对数线性回归模型，以评估APP和耳鼻喉科医生每年每10,000名受益人的DFL、VLS以及DFL和VLS合并量的趋势。
结果： 对数线性分析表明，全国年度DFL和VLS合并密度无显著变化（P = 0.786）。相反，对数线性分析表明全国年度VLS密度显著增加（P < 0.001），从2015年的每10,000名受益人19.7增加到2023年的29.6（CAGR +5.2%）。从2015年到2023年，APP年度DFL和VLS合并密度增加（CAGR +17.2%），而对数线性模型估计每年增长约16.0%（P < 0.001）。与此同时，耳鼻喉科医生的DFL和VLS合并密度无显著变化（P = 0.085）。到2023年，APP在七个州贡献了年度DFL和VLS合并密度的20%以上。
结论： 虽然耳鼻喉科医生仍然是DFL和VLS的主要提供者，但APP的全国年度DFL、VLS以及DFL和VLS合并密度正在迅速增长。耳鼻喉科医生全国年度DFL和VLS合并密度无显著变化，表明尽管APP相关增长迅速，耳鼻喉科医生的使用量保持稳定。全国年度VLS使用量的显著增长表明VLS的采用率不断增加。这些发现表明耳鼻喉科内手术选择正在演变且APP迅速增长，提示需要进一步研究不同提供者类型的手术培训和结局。
英文摘要
OBJECTIVES: This study aims to evaluate national trends and 2023 state-level variation in diagnostic flexible laryngoscopy (DFL) and videolaryngostroboscopy (VLS) utilization by physicians and advanced practice providers (APPs).
METHODS: This is a repeated cross-sectional analysis of Medicare Part B fee-for-service data from 2015 to 2023, collected in the annual Medicare Provider Utilization and Payment Data: Physician and Other Practitioners Public Use Files and the Medicare Monthly Enrollment data published by the Centers for Medicare and Medicaid Services. Compound annual growth rates (CAGR) and linear and log-linear regression models were calculated to assess trends in APP and otolaryngologist annual DFL, VLS, and combined DFL and VLS volume per 10,000 beneficiaries.
RESULTS: Log-linear analysis indicated no significant change in national annual combined DFL and VLS density (P = 0.786). Conversely, log-linear analysis indicated significant increases in national annual VLS density (P < 0.001) with an increase from 19.7 per 10,000 beneficiaries in 2015 to 29.6 in 2023 (CAGR +5.2%). From 2015 to 2023, APP annual combined DFL and VLS density increased (CAGR +17.2%), while the log-linear model estimates approximately 16.0% growth per year (P < 0.001). Meanwhile, otolaryngologist combined DFL and VLS density did not significantly change (P = 0.085). By 2023, APPs contributed over 20% of the annual combined DFL and VLS density in seven states.
CONCLUSIONS: While otolaryngologists remain the primary providers of DFL and VLS, APP national annual DFL, VLS, and combined DFL and VLS density is rapidly growing. Insignificant changes in otolaryngologist national annual combined DFL and VLS density suggest stable utilization by otolaryngologists despite rapid growth associated with APPs. The significant growth in national annual VLS utilization suggests increasing adoption of VLS. These findings suggest evolving procedure choices and rapid growth for APPs within otolaryngology, prompting further study of procedural training and outcomes across provider types.