Conoley P M, Vernon S W
Kelsey-Seybold Clinic, P. A., Houston, TX 77030.
AJR Am J Roentgenol. 1991 Dec;157(6):1337-40. doi: 10.2214/ajr.157.6.1950885.
Analysis of relative value units (RVUs) was used to quantify patient-care productivity of radiologists in 19 multispecialty group practices and to determine how productivity is affected by certain characteristics of the practices. The RVUs used in this study are the professional component RVUs developed by the American College of Radiology and the Health Care Financing Administration and published as the Radiology Relative Value Scale. An RVU workload was calculated by multiplying the number of times each procedure was performed by the procedure's corresponding RVU; the sum of these products gave the overall professional RVU workload. Five productivity indexes were calculated. The physician index denotes the ratio of the total number of physicians in the clinics to the total number of radiologists. The availability index denotes the fraction of radiologists who are available to perform clinical work after deductions are made for time away from clinical work. The difficulty index measures, in RVUs per examination, the level of complexity of the overall examination mix. The examination index measures examinations per available radiologist, and the RVU index measures RVUs per available radiologist. Altogether, the 19 clinics reported 3,234,451 examinations performed by 299 radiologists. The computed overall indexes were as follows: physician index = 20 physicians per radiologist; availability index = 0.77; difficulty index = 2.27 RVUs per examination; examination index = 14,098 examinations per year per available radiologist; RVU index = 32,065 RVUs per year per available radiologist. When the clinics were grouped according to characteristics of the practices, the RVU index was higher for single-site practices, high-prepaid practices, outpatient-only practices, and practices without radiology training programs. Fifty-two percent of the RVUs were in general radiology, 37% in sectional imaging, and 10% in special procedures. The concept of RVU workload is timely because it undoubtedly will be used to compare workloads across medical subspecialties, and these workloads are likely to be related by third-party payers to compensation.
采用相对价值单位（RVU）分析来量化19家多专科集团诊所中放射科医生的患者护理生产力，并确定生产力如何受到诊所某些特征的影响。本研究中使用的RVU是由美国放射学会和医疗保健财务管理局制定并作为放射学相对价值量表发布的专业成分RVU。通过将每个程序执行的次数乘以该程序相应的RVU来计算RVU工作量；这些乘积的总和给出了总体专业RVU工作量。计算了五个生产力指标。医生指标表示诊所医生总数与放射科医生总数的比率。可用率指标表示扣除非临床工作时间后可用于进行临床工作的放射科医生比例。难度指标以每次检查的RVU衡量总体检查组合的复杂程度。检查指标衡量每位可用放射科医生的检查次数，RVU指标衡量每位可用放射科医生的RVU。总体而言，这19家诊所报告了由299名放射科医生进行的3,234,451次检查。计算出的总体指标如下：医生指标=每位放射科医生20名医生；可用率指标=0.77；难度指标=每次检查2.27个RVU；检查指标=每位可用放射科医生每年14,098次检查；RVU指标=每位可用放射科医生每年32,065个RVU。根据诊所的特征进行分组时，单站点诊所、高预付诊所、仅门诊诊所以及没有放射学培训项目的诊所的RVU指标较高。52%的RVU用于普通放射学，37%用于断层成像，10%用于特殊程序。RVU工作量的概念很及时，因为它无疑将用于比较各医学亚专业的工作量，而且这些工作量很可能会被第三方付款人与薪酬挂钩。
