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 nonw hite patients) that are reported to have low rates of utilization of c ardiovascular services, Over an 18-month period we collected informati on on payments to physicians by 3,194 consecutive patients who underwe nt stress testing and 833 consecutive patients who underwent percutane ous coronary angioplasty at the Yale University Cardiology Practice. A lthough the charges for procedures were not related to patient charact eristics, there were large and significant differences in payment to p hysicians based on age, sex, and race. For example, physicians who per formed percutaneous transluminal coronary angioplasty received at leas t $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 ye ars 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 associati ons were largely explained by differences in insurance status.