Purpose

There is evidence of practice consolidation in US health care in recent years. To our knowledge, a detailed quantitative study of recent changes in radiation oncology practice size has not been performed. We aim to evaluate radiation oncology practice size changes between 2012 and 2020 in the United States.

Materials and Methods

Using the Medicare Physician Compare Database, we identified practices employing radiation oncologists using their taxpayer identification number and individual radiation oncologists using their national provider identifier. We grouped individual radiation oncologists into categories by practice size (which includes the number of physicians of all specialties) and compared the number of radiation oncologists in each category between 2012 and 2020. Further analyses by US geographic census region, single-specialty practice, academic practice, and high- and low-population density areas were performed.

Results

Between 2012 and 2020, the total number of practicing radiation oncologists increased by 9%, and the number of practices employing radiation oncologists decreased by 11.5%. The number of radiation oncologists in practices of size 1 to 2, 3 to 9, 10 to 24, and 25 to 49 decreased by 3.7%, 4.7%, 4.9%, and 2%, respectively, and the number of radiation oncologists in practices of size 50 to 99, 100 to 499, and 500+ increased by 1.4%, 2.1%, and 11.8%, respectively (all 500+ practices are multispecialty groups). The increase in practice size was significant in all regions, for single-specialty and multispecialty practices, academic and nonacademic practices, and for practices in high-, middle-, and low-population density areas (P < .05 for all comparisons). The proportion of single-specialty practices has decreased significantly (P < .001), and the proportion of academic practices increased significantly (P = .004). Additionally, the proportion of practices and physicians in high- and low-population density regions remained stable during this period (P > .05).

Conclusions

Our analysis suggests that practice size consolidation has occurred within the US radiation oncology workforce from 2012 to 2020. The impact of this consolidation on quality, cost, and patient access deserves further attention.

中文翻译：

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放射肿瘤学实践规模整合的定量分析：实践越来越少的趋势

目的

近年来，有证据表明美国医疗保健领域的实践整合。据我们所知，尚未对放射肿瘤学实践规模的近期变化进行详细的定量研究。我们的目标是评估 2012 年至 2020 年美国放射肿瘤学实践规模的变化。

材料和方法

使用 Medicare Physician Compare 数据库，我们确定了雇用放射肿瘤学家使用其纳税人识别号的做法，以及使用其国家提供者标识符的个人放射肿瘤学家的做法。我们按执业规模（包括所有专科医师的数量）将个体放射肿瘤学家分组，并比较了 2012 年至 2020 年每个类别中放射肿瘤学家的数量。按美国地理人口普查区域、单一专科实践、学术实践，并进行了高和低人口密度地区。

结果

2012 年至 2020 年间，放射肿瘤医师执业总数增加了 9%，放射肿瘤医师执业人数下降了 11.5%。规模为 1 至 2、3 至 9、10 至 24 和 25 至 49 的放射肿瘤学家人数分别减少了 3.7%、4.7%、4.9% 和 2%，放射肿瘤医师的数量减少了50 到 99、100 到 499 和 500+ 的比例分别增加了 1.4%、2.1% 和 11.8%（所有 500+ 实践都是多专业组）。所有地区的实践规模都显着增加，包括单专业和多专业实践、学术和非学术实践以及高、中、低人口密度地区的实践（P< .05 对于所有比较）。单一专业实践的比例显着下降（P < .001），学术实践的比例显着增加（P  = .004）。此外，高、低人口密度地区的执业和医生比例在此期间保持稳定（P > .05）。

结论

我们的分析表明，从 2012 年到 2020 年，美国放射肿瘤学劳动力发生了实践规模整合。这种整合对质量、成本和患者访问的影响值得进一步关注。