The provision of sterilization services by private physicians

Abstract

Obstetrician-gynecologists are 4-5 times more likely to perform female sterilizations, and urologists are 2-3 times more likely to perform vasectomies, than are general surgeons or general or family practitioners. Catholics are less likely to perform either procedure than are non-Catholics. Participation in a group practice and having a practice in the North Central region of the country are associated with carrying out a larger average number of both male and female sterilizations. More than half of female sterilizations are performed as inpatient hospital procedures, and most of the remainder are done in hospitals on an outpatient basis. Two-thirds of vasectomies, on the other hand, are performed in doctors' offices, while most of the rest are performed as hospital outpatient procedures. About one vasectomy in 12, however, is performed on an inpatient basis--possibly because general anesthesia is used, or the procedure is performed along with other surgery. The average cost for an inpatient female sterilization in 1982 was $1,335. The cost for a hospital outpatient sterilization was not much less than that. The total cost of a vasectomy ranged from an average of $511 for an inpatient procedure to $240 for one performed in the office. The average cost is higher when the sterilization is performed by an obstetrician-gynecologist or a urologist than when the service is provided by a general surgeon or general/family practitioner. Fifty-eight percent of physicians performing female sterilizations accept Medicaid reimbursement, and 12 percent reduce their fees to accommodate low-income patients. The proportions for doctors who perform vasectomies are 51 percent and 12 percent.(ABSTRACT TRUNCATED AT 250 WORDS)

PIP: Obstetrician-gynecologists are 4-5 times more likely to perform vasectomies, than are general surgeons or general or family practitioners. Catholics are less likely to perform either procedure than are nonCatholics. Particiaption in a group practice and having a practice in the North Central region of the country are associated with carrying out a larger average number of both male and female sterilizations. More than 1/2 of female sterilizations are performed as inpatient hospital procedures, and most of the remainder are done in hospitals on an outpatient basis. 2/3 of vasectomies, on the other hand, are performed in doctors' offices, while most of the rest are performed as hospital outpatient procedures. About 1 vasectomy in 12, however, is performed on an inpatient basis--possibly because general anesthesia is used, or the procedure is performed along with other surgery. The average cost for an inpatient female sterilization in 1982 was US$1335. The cost for a hospital outpatient sterilization was not much less than that. The total cost of a vasectomy ranged from an average of US$511 for an inpatient procedure to US$240 for 1 performed in the office. The average cost is higher when the sterilization is performed by an obstetrician-gynecologist or a urologist than when the service is provided by a general surgeon or general/family practitioner. 58% of physicians performing female sterilizations accept Medicaid reimbursement, and 12% reduce their fees to accomodate low-income patients. The proportions for doctors who perform vasectomies are 51% and 12%. Private physicians most likely to make these attempts to be financially accessible to the poor are those who are located in nonmetropolitan areas and those who practice in the North Central region of the coutnry. A group practice is also associated with fiancial accessibility among providers of vasectomy, as is specialization in either general surgery or general/family practice among providers of female sterilization.