Disparities in Industry Payments to Orthopedic Surgeons: A Retrospective Observational Analysis of Institutional Prestige and Financial Distribution

Résumé fourni par la source

Financial relationships between orthopedic surgeons and industry partners shape innovation and surgical advancements, yet these payments are highly concentrated among a small subset of surgeons. This retrospective observational analysis examines industry payment disparities using the Centers for Medicare & Medicaid Services (CMS) Open Payments Database for 2021, comparing payments between orthopedic surgeons affiliated with U.S. News & World Report (USNWR) top 10 orthopedic centers and those at large academic medical centers in the 25 most populous U.S. states. A total of 1,612 surgeons were included. Industry payments exhibited a right-skewed distribution, with a Gini coefficient of 0.91 for USNWR institutions and 0.93 for state-based academic centers, indicating significant financial stratification. Royalty and licensing fees accounted for 93.25% of payments exceeding $500,000, disproportionately benefiting surgeons at USNWR-ranked institutions. Surgeons at these institutions had 3.01 times higher odds of receiving over $500,000 in payments compared to those at state medical centers (OR = 3.01, 95% CI: 1.50-6.04, p < 0.001). Geographic disparities were also significant, with payments concentrated in states housing top-tier orthopedic programs. These findings highlight the role of institutional prestige in industry compensation and raise ethical considerations regarding equity in financial relationships and access to industry collaborations.

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