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Trends in payments among male and female ophthalmologists in Ontario from 1992 to 2018

Published:August 24, 2021DOI:https://doi.org/10.1016/j.jcjo.2021.07.011

      Abstract

      Objective

      To examine sex differences in Ontario Health Insurance Plan (OHIP) payments from 1992 to 2018.

      Design

      Population-based observational study.

      Participants

      Ophthalmologists submitting claims to OHIP from 1992 to 2018.

      Methods

      Physician billing data over 27 years (1992–2018) were analyzed for yearly number of ophthalmologists, OHIP payments, distinct patients, and patient visits.

      Results

      Yearly median OHIP payments to female ophthalmologists were less than to male ophthalmologists with a gap ratio of 0.55 in 1992 to 0.73 in 2018. Stratifying by full-time equivalent (FTE), there was little difference in median payments between males and females for 1 FTE. Median female-to-male payments ratio varied from 0.80 to 1.16 for <1 FTE and 1.14 to 0.84 for >1 FTE from 1992 to 2018. Among female ophthalmologists, 72.7% and 52.9% were <1 FTE and 11.4% and 19.2% were >1 FTE in 1992 and 2018, respectively. In comparison, for male ophthalmologists, 35.7% and 45.6% were <1 FTE and 43.4% and 45.6% were >1 FTE in 1992 and 2018, respectively. Overall, male ophthalmologists had more patients and patient visits than female ophthalmologists, but there was little difference between male and female ophthalmologists for 1 and >1 FTE. The results for <1 FTE varied by year.

      Conclusions

      Overall, female ophthalmologists have lower OHIP payments compared with males, but there was little difference for those stratified to 1 FTE. This overall payments difference by sex is largely explained by the higher proportion of <1 FTE females, lower proportion of >1 FTE females, and higher payments for >1 FTE males.

      Résumé

      Objectif

      Examiner les différences entre les sexes quant à la facturation auprès de l'Assurance-santé de l'Ontario entre 1992 et 2018.

      Nature

      Étude d'observation populationnelle.

      Participants

      Ophtalmologistes qui ont soumis des factures auprès de l'Assurance-santé de l'Ontario entre 1992 et 2018.

      Méthodes

      Les données de facturation soumises par des médecins sur une période de 27 ans (1992–2018) ont été analysées en fonction du nombre annuel d'ophtalmologistes, des paiements par l'Assurance-santé de l'Ontario, du nombre de patients distincts et du nombre de visites par les patients.

      Résultats

      Les paiements annuels médians de l'Assurance-santé de l'Ontario à des femmes ophtalmologistes étaient moins élevés que les paiements à des hommes ophtalmologistes, l'indice d’écart se chiffrant à 0,55 en 1992 et à 0,73 en 2018. Une fois les résultats stratifiés en équivalent temps plein (ETP), on note peu de différence quant aux paiements médians entre hommes et femmes pour chaque 1 ETP. Le rapport médian des paiements entre femmes et hommes variait de 0,80 à 1,16 pour < 1 ETP et de 1,14 à 0,84 pour > 1 ETP entre 1992 et 2018. Chez les femmes ophtalmologistes, on note 72,7 % et 52,9 % de < 1 ETP et 11,4 % et 19,2 % de > 1 ETP en 1992 et en 2018, respectivement. Par comparaison, chez leurs collègues masculins, on note 35,7 % et 45,6 % de < 1 ETP et 43,4 % et 45,6 % de > 1 ETP en 1992 et en 2018, respectivement. Dans l'ensemble, les ophtalmologistes de sexe masculin avaient plus de patients et plus de visites de patients que leurs collègues féminines. Cependant, on observe peu de différence entre les 2 sexes quant à l'ETP (1 et > 1). Les résultats en matière de < 1 ETP variaient d'une année à l'autre.

      Conclusions

      Les femmes ophtalmologistes reçoivent moins de paiements de l'Assurance-santé de l'Ontario que les hommes, mais la différence était faible une fois les résultats stratifiés en fonction de 1 ETP. Cette différence de paiements en fonction du sexe s'explique en grande partie par la plus grande proportion de femmes < 1 ETP, une plus faible proportion de femmes > 1 ETP et l'attribution de paiements plus élevés aux hommes > 1 ETP.
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