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Resource-based relative values for invasive procedures performed by eight surgical specialties
W C Hsiao1, N P Couch, N Causino
1Department of Health Policy and Management, Harvard University School of Public Health, Boston, MA 02115.
JAMA
|October 28, 1988
Summary
Physician charges for invasive procedures do not reflect resource costs, with significant variations found. Pre- and post-operative work time doesn't align with service work, highlighting inefficiencies in physician resource-based relative value scales.
Area of Science:
- Health Economics
- Medical Practice Analysis
- Surgical Services Research
Background:
- Physician charges often do not correlate with the resources expended for procedures.
- Understanding the distribution of physician work is crucial for accurate service valuation.
Purpose of the Study:
- To analyze physician work in performing invasive services across surgical specialties.
- To develop a resource-based relative value scale for physician services.
- To compare physician charges with resource-based valuations.
Main Methods:
- Survey of approximately 850 physicians in eight surgical specialties.
- Analysis of physician work, including time and resource allocation.
- Development of a resource-based relative value scale (RBVS).
Main Results:
- Physician charges show a threefold variation compared to resource-based relative values for invasive procedures.
- Preoperative and postoperative periods constitute a larger proportion of physician time (60-75%) than work (35-50%).
- Intraoperative work intensity for invasive procedures is 2-3 times higher than for medical office visits.
Conclusions:
- The current physician charge system is not proportional to the resources required.
- The Resource-Based Relative Value Scale (RBVS) aids payers in identifying procedures with potentially aberrant charges.
- The study provides insights into the nature and distribution of physician work in surgical specialties.