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使用医疗事故相对价值单位评估放射学风险。

Assessment of risk in radiology using malpractice RVU.

作者信息

Cristofaro Massimo, Bellandi Giuseppe, Squarcione Salvatore, Petecchia Antonella, Mammarella Assunta, Bibbolino Corrado

机构信息

U.O. di Diagnostica per Immagini, Istituto Nazionale per le Malattie Infettive IRCCS, L. Spallanzani Via Portuense, 292, 00149 Rome, Italy.

出版信息

Eur J Radiol. 2007 Feb;61(2):367-71. doi: 10.1016/j.ejrad.2006.09.010. Epub 2006 Dec 20.

Abstract

INTRODUCTION

Analysis on the causes and remedies needed to reduce the incidence of malpractice has been under continual studies, although limited data is available regarding quantitative evaluation of the risk.

OBJECTIVES

To determine radiological risk in a preventive and quantitative manner and verify if the malpractice relative value units (MP-RVU) are a good indicator of associated risk factors.

MATERIALS AND METHODS

Radiological examinations executed by our Radiology Department in 2000-2004 have been codified according to nomenclature HCPCS (Healthcare Common Procedure Coding System) used by United States of America Centers for Medicare and Medicaid Services (CMS). For every examination was calculated the annual weight of malpractice. The data has been groupped in macroaggregates by methodology. The ratio MP-RVU/no. examinations has been considered as an index of insurance risk (MP index)

RESULTS

A total of 133,005 examinations were performed, which produced 25,252 MP-RVU points, the total mp index was 0.193. Traditional radiology represents 38% of the examinations, accounting for 8% of MP-RVU with a MP index=0.039. Ultrasound represents 35% of the examinations, accounting for 23% of MP-RVU with a MP index=0.125. CT represents 13% of the examinations, accounting for 28% of MP-RVU with a MP index=0.434. MR represents 11% of the examinations, accounting for 39% of MP-RVU with a MP index=0.667.

CONCLUSIONS

Malpractice relative value units (MP-RVU) are indicative of the risk considered globally and when subgrouped. MP index correlates this risk with number of exams carried out divided by methodology. This model providing quantitative data for projects concerning risk management and in allowing the correlation between data obtained in different departments.

摘要

引言

尽管关于风险定量评估的数据有限,但对减少医疗事故发生率所需的原因及补救措施的分析一直在持续进行研究。

目的

以预防和定量的方式确定放射学风险,并验证医疗事故相对价值单位(MP - RVU)是否是相关风险因素的良好指标。

材料与方法

我们放射科在2000 - 2004年进行的放射学检查已根据美国医疗保险和医疗补助服务中心(CMS)使用的医疗保健通用程序编码系统(HCPCS)命名法进行编码。对每次检查计算年度医疗事故权重。数据已按方法学分组为宏观集合。MP - RVU/检查次数的比率被视为保险风险指数(MP指数)。

结果

共进行了133,005次检查,产生了25,252个MP - RVU点,总MP指数为0.193。传统放射学占检查的38%,占MP - RVU的8%,MP指数 = 0.039。超声占检查的35%,占MP - RVU的23%,MP指数 = 0.125。CT占检查的13%,占MP - RVU的28%,MP指数 = 0.434。磁共振成像(MR)占检查的11%,占MP - RVU的39%,MP指数 = 0.667。

结论

医疗事故相对价值单位(MP - RVU)在整体及分组考虑时都能表明风险。MP指数将此风险与按方法学划分的检查次数相关联。该模型为风险管理项目提供定量数据,并允许不同部门获得的数据之间建立关联。

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