Bhargavan Mythreyi, Sunshine Jonathan H
Research Department, American College of Radiology, 1891 Preston White Dr., Reston, VA 20191, USA.
AJR Am J Roentgenol. 2002 Nov;179(5):1123-8. doi: 10.2214/ajr.179.5.1791123.
This article measures the workload of radiologists in the United States in 1998-1999, its variation by practice characteristics, and changes since 1995-1996.
Data on procedures performed were collected from the American College of Radiology's 1999 Survey of Practices, and responses were weighted to make them representative of all radiologists in the United States. Workload measured as number of procedures per full-time equivalent diagnostic radiologist was tabulated by practice type, size, setting, and location and compared with corresponding survey results from 1995-1996. The independent effect of these factors on workload was measured using regression analysis. Changes in procedure complexity were calculated in terms of relative value units (RVUs) per procedure using Medicare files.
In 1998-1999, the average workload per full-time equivalent diagnostic radiologist had increased 8.5% since 1995-1996 to 12,800 (standard error = 200) procedures annually, with substantial variation by group type. For example, the average workload was 9400 procedures in academic groups and 13,600 in nonacademic private radiology practices. Even in relatively homogeneous categories of practices, radiologists at the 75th percentile of workload were typically performing at least 50% more procedures than radiologists at the 25th percentile. Average RVUs per Medicare procedure increased by 4% between 1995 and 1998, mainly because of an increase in the share of more complex techniques such as MR imaging and CT in the procedure mix.
The workload per radiologist measured in procedures and RVUs increased substantially between 1995-1996 and 1998-1999. Because much variation remains unexplained, averages or medians should not be used as norms.
本文衡量了1998 - 1999年美国放射科医生的工作量、其因执业特征的变化情况以及自1995 - 1996年以来的变化。
从美国放射学会1999年的执业情况调查中收集了关于所执行程序的数据，并对回复进行加权处理，使其能代表美国所有放射科医生。以每位全职等效诊断放射科医生的程序数量来衡量工作量，按执业类型、规模、环境和地点进行列表，并与1995 - 1996年的相应调查结果进行比较。使用回归分析来衡量这些因素对工作量的独立影响。使用医疗保险档案，根据每个程序的相对价值单位（RVU）计算程序复杂性的变化。
在1998 - 1999年，每位全职等效诊断放射科医生的平均工作量自1995 - 1996年以来增加了8.5%，达到每年12,800例（标准误差 = 200）程序，不同组类型之间存在显著差异。例如，学术组的平均工作量为9400例程序，非学术私人放射科执业的平均工作量为13,600例程序。即使在相对同质的执业类别中，工作量处于第75百分位的放射科医生通常比处于第25百分位的放射科医生多执行至少50%的程序。1995年至1998年间，每个医疗保险程序的平均RVU增加了4%，主要是因为在程序组合中，诸如磁共振成像（MR）和计算机断层扫描（CT）等更复杂技术的占比增加。
在1995 - 1996年至1998 - 1999年期间，以程序和RVU衡量的每位放射科医生的工作量大幅增加。由于仍有许多差异无法解释，不应将平均值或中位数用作标准。
