{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:39:12Z","timestamp":1792395552526,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Shifting patterns in the financing of plastic surgery are not fully understood. We analyze payer trends for office and outpatient plastic surgery visits from 2002 to 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We investigated office\u2010based and hospital outpatient department plastic surgery visits in the Medical Expenditure Panel Survey, a national dataset of healthcare usage and expenditures. During the study period (2002\u20132022), we calculated the yearly median amount of money charged and paid per visit, the distribution of payer type expenditures, and the mean payment\u2010to\u2010charge ratio per visit. Dollar amounts were inflation\u2010adjusted to 2022 estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2002 to 2022, there were 5824 office\u2010based plastic surgery visits and 850 outpatient department plastic surgery visits, representing 71,597,980 and 10,589,575 total visits, respectively. For office\u2010based visits, the number of visits declined across the study period from 3,982,280 to 1,418,032 (\u221264.4%), the median (IQR) payment per visit increased from $119.06 ($188.49) to $263.48 ($721.35) (+121.3%), and the median (IQR) payment\u2010to\u2010charge ratio decreased from 0.71 (0.43) to 0.47 (0.45) (\u221233.8%). Payments were primarily private insurance (37.6%) and out\u2010of\u2010pocket (36.0%). For outpatient department visits, the median (IQR) payment\u2010to\u2010charge ratio also decreased significantly from 0.56 (0.44) to 0.35 (0.45) (\u221237.1%); median (IQR) payment per visit was $1587.93 ($1287.80) without significant changes over time. Most expenditures were from private insurance (58.5%), then self\u2010pay (17.8%), and Medicare (11.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>National trends in plastic surgery expenditures show decreasing payment\u2010to\u2010charge ratios for both office and outpatient department settings. However, the payer mix driving these trends differs by practice setting. Limitations of the study include survey\u2010based data, a small sample size, and the exploratory nature of the study with limited statistical analysis. Further research is warranted to uncover factors that may account for these findings and their implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73071","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:31:57Z","timestamp":1791271917000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["National Trends in Utilization and Expenditures for Plastic Surgery From 2002 to 2022: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4915-453X","authenticated-orcid":false,"given":"Jason","family":"Zhang","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5392-8433","authenticated-orcid":false,"given":"Anitesh","family":"Bajaj","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Nenchev","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1814-0847","authenticated-orcid":false,"given":"Timothy","family":"Burke","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7632-4699","authenticated-orcid":false,"given":"Matthew D.","family":"Ramsey","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9562-4630","authenticated-orcid":false,"given":"Hannah","family":"Soltani","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Northwestern University Feinberg School of Medicine Chicago Illinois 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