工作 RVU 中纳入的隐含强度值与客观测量的关联。
Association of implicit intensity values incorporated into work RVUs with objective measures.
机构信息
Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
出版信息
Am J Surg. 2020 Jun;219(6):976-982. doi: 10.1016/j.amjsurg.2019.09.022. Epub 2019 Sep 24.
BACKGROUND
The "intensity" of a surgical procedure is supposed to be incorporated into work RVUs to allow higher compensation rates for more complex procedures. However, updates to work RVUs are subjective and it is unclear if these intensity values correlate to objective measures of a procedure's complexity.
METHODS
Centers for Medicare and Medicaid Services (CMS) data were used to calculate intraservice intensity values for CPT codes in 2017 ("CMS intensity values"). Twenty-six objective measures- spanning patient, case, and risk characteristics - were generated using the 2017 participant use file from NSQIP. CMS intensity values were compared to objective measures using scatterplots and correlations.
RESULTS
Among 473 CPT codes, CMS intensity values ranged from 0.0031 to 0.142 work RVUs/minute. CMS intensity values were positively associated with 3 objective measures, negatively associated with 5 measures, and not associated with the remaining 18 measures.
CONCLUSIONS
Despite intensity values - and therefore compensation rates - varying over 40-fold in the wRVU scale, there was generally no association between their magnitude and objective measures of surgical intensity.
背景
手术的“强度”应该被纳入工作 RVU 中，以对更复杂的手术给予更高的补偿率。然而，工作 RVU 的更新是主观的，目前尚不清楚这些强度值是否与手术复杂性的客观衡量标准相关。
方法
使用医疗保险和医疗补助服务中心（CMS）的数据来计算 2017 年 CPT 代码的服务内强度值（“CMS 强度值”）。使用 NSQIP 的 2017 年参与者使用文件生成了 26 个客观指标-涵盖患者、病例和风险特征。使用散点图和相关性比较 CMS 强度值与客观指标。
结果
在 473 个 CPT 代码中，CMS 强度值从 0.0031 到 0.142 个工作 RVU/分钟不等。CMS 强度值与 3 个客观指标呈正相关，与 5 个指标呈负相关，与其余 18 个指标不相关。
结论
尽管工作 RVU 规模的 CMS 强度值变化超过 40 倍，但它们的幅度与手术强度的客观衡量标准之间通常没有关联。
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