Differences in physician compensation for cardiovascular services by age, sex, and race.
The purpose was to determine whether physicians receive substantially less compensation from patient groups (women, older patients, and nonwhite patients) that are reported to have low rates of utilization of cardiovascular services. Over an 18-month period we collected information on payments to physicians by 3,194 consecutive patients who underwent stress testing an 833 consecutive patients who underwent percutaneous coronary angioplasty at the Yale University Cardiology Practice. Although the charges for procedures were not related to patient characteristics, there were large and significant differences in payment to physicians based on age, sex, and race. For example, physicians who performed percutaneous transluminal coronary angioplasty received at least $2,500 from, or on behalf of, 72% of the patients 40 to 64 years old, 22% of the patients 65 to 74 years old, and 3% of the patients 75 years and older (P < 0.001); from 49% of the men and 28% of the women (P < 0.001); and 42% of the whites and 31% of the nonwhites (P < 0.001). Similar differences were observed for stress testing. These associations were largely explained by differences in insurance status.
Krumholz
H M
HM
Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
Fendrick
A M
AM
Williams
C
C
Hynes
W M
WM
D000367:Age Factors; D000368:Aged; D000800:Angioplasty, Balloon / Q000191:economics* / Q000706:statistics & numerical data; D003237:Connecticut; D003710:Demography; D005006:Ethnicity; D005080:Exercise Test / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D010361:Patients / Q000145:classification*; D010820:Physicians / Q000191:economics*; D012737:Sex Factors; D017664:Uncompensated Care / Q000706:statistics & numerical data; D014481:United States