在生产力指标中比较全职等价和临床时间劳动投入量
Iman Saeed1, Kyle Barr, Sivagaminathan Palani
1VA Boston Healthcare System and Boston University School of Public Health, Boston, Massachusetts.
概括
准确测量临床生产率至关重要. 一个新的指标"诊所时间"为评估提供者生产力和改善护理提供了更可靠的全职等效 (FTEs) 替代方案.
科学领域:
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
- 临床操作 临床操作
背景情况:
- 医疗保健提供者生产力的低最佳测量可能会阻碍诊所运营的改进.
- 工作相对价值单位 (RVU) 常用于衡量生产力,通常是通过将RVU与全职等价单位 (FTEs) 进行比较.
- FTEs缺乏通用的定义,可能导致不准确的生产力评估.
研究的目的:
- 引入和验证"临床时间"作为临床劳动投入的新和更准确的衡量标准.
- 为了将拟议的"诊所时间"指标与评估提供者生产力的传统基于FTE的指标进行比较.
主要方法:
- 一项使用集群随机试验数据的观察性验证研究,涉及退伍军人卫生管理局 (VA) 心脏病和骨科提供者 (2018-2020).
- 使用图形分析,比较生产力指标 (每日诊所患者与每日FTE患者).
- 通过普通最小平方 (OLS) 和仪表变量 (IV) 回归模型进行验证,使用联邦假日作为调整内质性的工具.
主要成果:
- 每个临床日的患者总是比每天每FTE的患者产生更高的值.
- 与FTE相比,IV回归在预测等待时间方面对"临床时间"的效果大得多.
- "临床时间"减轻了与FTE数据相关的偏差,例如自我报告偏差和低报告频率.
结论:
- 准确的生产力测量对于有效的诊所运营和改善患者护理结果至关重要.
- "诊所时间"是评估提供者生产力的更有效,更可靠的指标.
- 采用"诊所时间"是一种提高长期医疗保健提供成本效益的战略.
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