●.美國公立醫學院醫師薪資之性別差異

Sex Differences in Physician Salary in US Public Medical Schools
Anupam B. Jena, MD, PhD1,2,3; Andrew R. Olenski, BS1; Daniel M. Blumenthal, MD, MBA4,5 

1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 
2Department of Medicine, Massachusetts General Hospital, Boston 
3National Bureau of Economic Research, Cambridge, Massachusetts 
4Cardiology Division, Massachusetts General Hospital, Boston 
5Harvard Medical School, Boston, Massachusetts

JAMA Intern Med. 2016;176(9):1294-1304. doi:10.1001/jamainternmed.2016.3284.

 研究原文 :http://archinte.jamanetwork.com/article.aspx?articleid=2532788

摘要


研究重要性

關於男性和女性學術型醫師之間薪資差異的證據並不是很多,主要是由於很難獲得薪資和影響薪資水平因素的資料。現有的研究則大多有所局限,它們或者仰賴以調查為基礎的方法來衡量收入的性別差異,或者缺乏最新數據,或者樣本量太小,抑或地域代表性有限。

 

研究目的 分析美國學術型醫師收入之性別差異。

研究設計、研究情境和研究參與者

在美國的某些州,「資訊自由法」強制規定公立大學僱員的薪資信息必須要公佈。在其中12個州裡,薪資信息會公佈在網路上,研究者從而提取了來自24所公立醫學院共計10241名學術型醫師的薪資數據。然後這些數據被連接至一個專門的醫師數據庫,該數據庫包含各種詳細信息例如性別、年齡、資歷、職稱、專、科學著作權、國立衛生研究所經費、臨床實驗參與度以及醫療保險報銷金(替代臨床收益)。研究者將上述各因素納入考量後,對薪資的性別差異進行了評估。

研究方向 醫師、性別

主要成果和測度 年薪

研究結果  

10241名醫師中,若不考量年齡和經驗等因素,與男醫師相比,女醫師(共3549人)的平均年薪(標準差)呈現較低水平。具體來說,女醫師平均年薪為206641美元 (標準差為88238美元),男醫師平均年薪為257957美元 (標準差為137202美元),兩者之間的絕對差異為51315美元(95%信賴區間,區間介於46330美元至56301美元[1])。 而進行多變項分析之後,調整後年薪的性別差異依然存在。具體來說,女醫師為227783美元(95%信賴區間,區間介於224117美元至231448美元),而男醫師為247661美元(95%信賴區間,區間介於245065美元至250258美元);兩者之間絕對差異為19878美元(95%信賴區間,區間介於15261美元至24495美元)。此外,薪資的性別差異也因專科、機構以及職稱的不同而變化。例如,在多變項分析之後,女性正教授的調整年薪為250971美元(95%信賴區間,區間介於242307美元至259635美元),僅僅與男性副教授的薪資水平相當,後者的調整年薪為247212美元(95%信賴區間,區間介於241850美元至252575美元)。在各個專科當中,調整年薪最高的是整形外科醫師,為358093美元(95%信賴區間,區間介於344354美元至371831美元),其次是外科專科醫師的318760美元(95%信賴區間,區間介於311030美元至326491美元)以及普通外科醫師的302666美元(95%信賴區間,區間介於294060美元至311272美元);而年薪最低的則是傳染性疾病、家庭醫學和神經學醫師(平均收入少於20萬美元)。最後,年資、研究發表總量、臨床試驗參與度以及醫療保險支付金與薪資水平呈現正相關。

研究結論和相關性 

在美國24所公立醫學院受聘為教師的醫師當中,即使在考量了年齡、經驗、專科、職稱以及研究產出和臨床收益測量這些因素之後,薪資水平仍然存在著顯著的性別差異。


[1] 意思是在95%的信心水平下,男女醫師平均年薪的差額會落在46330美元至56301美元的區間之內。

 

 

 

ABSTRACT

 

Importance  Limited evidence exists on salary differences between male and female academic physicians, largely owing to difficulty obtaining data on salary and factors influencing salary. Existing studies have been limited by reliance on survey-based approaches to measuring sex differences in earnings, lack of contemporary data, small sample sizes, or limited geographic representation.

Objective  To analyze sex differences in earnings among US academic physicians.

Design, Setting, and Participants  Freedom of Information laws mandate release of salary information of public university employees in several states. In 12 states with salary information published online, salary data were extracted on 10 241 academic physicians at 24 public medical schools. These data were linked to a unique physician database with detailed information on sex, age, years of experience, faculty rank, specialty, scientific authorship, National Institutes of Health funding, clinical trial participation, and Medicare reimbursements (proxy for clinical revenue). Sex differences in salary were estimated after adjusting for these factors.

Exposures  Physician sex.

Main Outcomes and Measures  Annual salary.

Results  Among 10 241 physicians, female physicians (n = 3549) had lower mean (SD) unadjusted salaries than male physicians ($206 641 [$88 238] vs $257 957 [$137 202]; absolute difference, $51 315 [95% CI, $46 330-$56 301]). Sex differences persisted after multivariable adjustment ($227 783 [95% CI, $224 117-$231 448] vs $247 661 [95% CI, $245 065-$250 258] with an absolute difference of $19 878 [95% CI, $15 261-$24 495]). Sex differences in salary varied across specialties, institutions, and faculty ranks. For example, adjusted salaries of female full professors ($250 971 [95% CI, $242 307-$259 635]) were comparable to those of male associate professors ($247 212 [95% CI, $241 850-$252 575]). Among specialties, adjusted salaries were highest in orthopedic surgery ($358 093 [95% CI, $344 354-$371 831]), surgical subspecialties ($318 760 [95% CI, $311 030-$326 491]), and general surgery ($302 666 [95% CI, $294 060-$311 272]) and lowest in infectious disease, family medicine, and neurology (mean income, <$200 000). Years of experience, total publications, clinical trial participation, and Medicare payments were positively associated with salary.

Conclusions and Relevance  Among physicians with faculty appointments at 24 US public medical schools, significant sex differences in salary exist even after accounting for age, experience, specialty, faculty rank, and measures of research productivity and clinical revenue.

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