量化与门诊,一般内科医学中的性别生产力差距相关的EHR和政策因素
Huan Li1,2, Lisa Rotenstein3,4, Molly M Jeffery5,6
1Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA.
Journal of general internal medicine
|October 16, 2023
概括
考虑到电子健康记录 (EHR) 使用和其他因素后,医生性别对生产率没有影响. 团队支持和文档变化,比如2021年EM代码更新,提高了医生生产力,可能会使女性医生受益.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学经济学 医学经济学
- 医生劳动力研究 医生劳动力研究
背景情况:
- 医生薪酬中持续存在的性别差距仍然是一个重大问题.
- 在这种差异中,电子健康记录 (EHR) 使用的作用尚不清楚.
研究的目的:
- 根据医生性别分析临床活动时间,EHR时间和临床生产力的变化.
- 确定影响医生生产力的因素.
主要方法:
- 从2018年8月到2021年6月,对一般内科医生的纵向研究.
- 分析每个月的数据,包括工作相对值单位 (wRVU),医生和实践特征,EHR指标和笔记内容.
- 多变量调整医生年龄,实践特征,电子病历使用和时间趋势.
主要成果:
- 与男性相比,女性医生每月产生较少的wRVU23.8%,并完成较少的月度访问22.1%.
- 女性医生每次访问花费更多的时间在临床活动和电子健康记录上,并且每笔记输入更多的字符.
- 在多变量调整后,医生性别与生产力 (wRVU/小时) 没有关联.
- 与更高的生产率相关的因素包括在文档上花费更少的时间,更多的团队合作,以及2021年E/M代码的更改,这对女性医生有不成比例的好处.
结论:
- 增加团队支持,简化文档和2021年EM代码更改与更高的医生生产力有关.
- 2021年E/M代码的变化可能对女性医生产生了积极的影响,因为她们在历史上更频繁地进行了时间密集的临床活动.
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