尽管已进行了大量研究，比较了显微经蝶窦手术 (MTSS) 和内窥镜经蝶窦手术 (ETSS) 方法之间的患者预后，但近期对这两种技术在全国范围内的利用和报销趋势的调查相对较少。本研究旨在确定垂体肿瘤手术利用、向医疗保险缴费以及医疗保险赔付与 (1) MTSS/ETSS 手术类型、(2) 提供者类型 (即神经外科医生 vs 耳鼻喉科医生) 和 (3) 合作性手术状态有关的趋势。本研究使用 2010-2020 年的医疗保险医生/供应商手术摘要的公开可得数据。采用线性回归分析量化 2010-2020 年期间提交服务次数、提交费用、赔付和费用/赔付比的时间趋势。关于 2010 年至 2020 年期间的服务次数趋势，我们的结果表明 ETSS 利用率显著增加 ( = 1.55，CI = 0.99-2.12，P < .001)，MTSS 利用率显著减少 ( = -0.86，CI = -1.21 至 -0.51，P < .001)，耳鼻喉科医生提交的服务显著增加 ( = 0.59，CI = 0.24-0.93，P = .0040)，并且合作手术显著增加 ( = 1.03，CI = 0.24-0.93，P = .0051)。重要的是，我们的结果还显示 ETSS 手术的费用赔付显著减少 ( = -12.74，CI = -22.38 至 -3.09，P = .015)，以及神经外科医生提交的垂体肿瘤手术的费用赔付显著减少 ( = -41.56，CI = -51.67 至 -31.63，P < .0001)。我们的结果显示 ETSS 利用率显著增加，MTSS 利用率显著减少。我们还注意到 ETSS 手术和神经外科医生提交的手术费用赔付显著减少。希望本研究突出了全国利用和费用赔付模式，这对于指导未来的以费用赔付为导向的政策制定可能很有用。版权所有 © 2023 年神经外科大会。保留所有权利。

Despite the extensive amount of research aimed at comparing patient outcomes between microscopic transsphenoidal surgery (MTSS) and endoscopic transsphenoidal surgery (ETSS) approaches, there has been relatively little recent investigation into the nationwide utilization and reimbursement trends of both techniques. This study aimed to identify trends in pituitary tumor surgery utilization, charges to Medicare, and reimbursement dependent on (1) MTSS/ETSS surgery type, (2) provider type (ie, neurosurgeon vs ear, nose, and throat), and (3) cosurgery status.This study used publicly available data from the Medicare Physician/Supplier Procedure Summary for the years 2010-2020. Linear regression was used to quantify temporal trends for submitted service counts, submitted charges, reimbursements, and reimbursement-to-charge across the 2010-2020 period.Regarding service count trends from 2010 to 2020, our results demonstrate a significant increase in ETSS utilization ( = 1.55, CI = 0.99-2.12, P < .001), a significant decrease in MTSS utilization ( = -0.86, CI = -1.21 to -0.51, P < .001), a significant increase in services submitted by otolaryngologists ( = 0.59, CI = 0.24-0.93, P = .0040), and a significant increase in cosurgeries ( = 1.03, CI = 0.24-0.93, P = .0051). Importantly, our results also demonstrated a significant decrease in reimbursements for ETSS procedures ( = -12.74, CI = -22.38 to -3.09, P = .015) and for pituitary tumor surgeries submitted by neurosurgeons specifically ( = -41.56, CI = -51.67 to -31.63, P < .0001).Our results demonstrated a significant increase in ETSS utilization and a significant decrease in MTSS utilization. We also noted a significant decrease in reimbursements for ETSS procedures and among procedures submitted by neurosurgeons specifically. We hope that our study highlights nationwide utilization and reimbursement patterns that may be useful for guiding future reimbursement-oriented policy development.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.