耳鼻喉科Pubmed文献追踪每日 14:00 同步
← 返回全部文献
Article record

基于理赔数据的门诊耳鼻咽喉科医疗趋势：执业护士与医师助理的贡献

Claims-Based Trends in Outpatient Otolaryngology Care: Contributions of Nurse Practitioners and Physician Associates.

临床研究耳科IF 2.9Q1

文献信息

PMID42891572
原文在 PubMed 查看原文 ↗
发表日期2026
作者Nicholas R Lenze
查看其他 6 位作者

Aya M Dakroub；Chamila D Perera；Howard J Ritz；Vinciya Pandian；Michael J Brenner；Pratyusha Yalamanchi

作者单位Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
查看其他 5 条单位信息

University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA.；Albany Med Health System, Glens Falls, New York, USA.；Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA.；Center for Immersive Learning and Digital Innovation, The Pennsylvania State University, University Park, Pennsylvania, USA.；Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.

期刊Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
SCI 分区Q1
IF2.9
研究类型临床研究 · 临床
所属专科耳科

中文摘要

目的： 评估由执业护士（NP）和医师助理（PA）计费的门诊耳鼻咽喉科服务在时间和地理上的趋势。
研究设计： 系列横断面分析。
研究场所： 全国商业理赔数据库。
方法： 我们查询了Merative MarketScan数据库中2009年至2023年间接受25种常见门诊耳鼻咽喉科操作或服务的18至64岁成人。专业理赔按提供者类型（NP/PA vs 医师）分类。我们评估了NP/PA计费理赔比例的趋势，并比较了NP/PA与医师理赔的特征。
结果： 共有12,099,097条耳鼻咽喉科特异性理赔，其中423,635条（3.5%）由NP/PA计费；另有14,130,340条耳鼻咽喉科相关理赔，其中3,800,352条（26.9%）由NP/PA计费。归因于NP/PA的耳鼻咽喉科特异性理赔比例增加超过十倍，从2009年的1.1%增至2023年的12.9%（P < .001），且与医师相比，这些理赔更可能位于农村地区（18.4% vs 9.0%；P < .001）。按NP/PA计费理赔百分比排名，北达科他州、南达科他州和佛蒙特州位居前列，而佐治亚州和南卡罗来纳州在耳鼻咽喉科特异性理赔和耳鼻咽喉科相关理赔中均处于末位。由NP/PA计费的理赔更可能涉及较年轻、男性、在职患者，以及拥有高免赔额健康计划和网络内保险计划的患者（所有P < .001）。
结论： 过去十年中，由NP/PA计费的门诊耳鼻咽喉科操作大幅增加，并在农村地区占理赔比例更高。

英文摘要

OBJECTIVE: To evaluate temporal and geographic trends in outpatient otolaryngology services billed by nurse practitioners (NPs) and physician associates (PAs).
STUDY DESIGN: Serial cross-sectional analysis.
SETTING: National commercial claims database.
METHODS: We queried Merative MarketScan for adults aged 18 to 64 who received 25 common outpatient otolaryngology procedures or services from 2009 to 2023. Professional claims were categorized by provider type (NP/PA vs physician). We assessed trends in the proportion of claims billed by NPs/PAs and compared characteristics between NP/PA and physician claims.
RESULTS: There were 12,099,097 otolaryngology-specific claims, among which 423,635 (3.5%) were billed by NPs/PAs, and 14,130,340 otolaryngology-relevant claims, among which 3,800,352 (26.9%) were billed by NPs/PAs. The proportion of otolaryngology-specific claims attributable to NPs/PAs increased more than tenfold, from 1.1% in 2009 to 12.9% in 2023 (P < .001), and these claims were more likely to be in rural areas compared to physicians (18.4% vs 9.0%; P < .001). North Dakota, South Dakota, and Vermont were among the top states by percentage of claims attributable to NPs/PAs, while Georgia and South Carolina were among the bottom states for both otolaryngology-specific and otolaryngology-relevant claims. Claims billed by NPs/PAs were more likely to be for younger, male, and actively employed patients, and those with high-deductible health plans and in-network insurance plans (P < .001 for all).
CONCLUSION: Outpatient otolaryngology procedures billed by NPs/PAs have increased substantially over the past decade and account for a greater share of claims in rural areas.