Dunn D, Hsiao W C, Ketcham T R, Braun P
Department of Health Policy and Management, Harvard University School of Public Health, Boston, MA 02115.
JAMA. 1988 Oct 28;260(16):2371-8.
The goal of the Resource-Based Relative Value Scale is to measure the resource costs of physicians' services, or, more centrally, the physicians' total work. This article describes the estimation of relative values for physicians' work before and after the performance of a service (preservice and postservice work). For methodological and practical reasons, we could not obtain direct ratings of preservice and postservice work except for a few services. We therefore developed a systematic process to estimate preservice and postservice time and rate of work per unit of time. Then time and work per unit of time were multiplied to estimate work. The major finding of our investigation is that preservice and postservice work make up a substantial portion of total work. The typical percentages of total work accounted for by preservice and postservice work range from 26% and 33% for imaging services and evaluation and management services, respectively, to 46% for invasive services performed in a hospital inpatient setting.
基于资源的相对价值尺度的目标是衡量医生服务的资源成本，或者更核心地说，是医生的总工作量。本文描述了服务执行之前和之后（服务前和服务后工作）医生工作相对价值的估算。出于方法和实际原因，除了少数服务外，我们无法获得服务前和服务后工作的直接评级。因此，我们开发了一个系统的流程来估算服务前和服务后时间以及单位时间的工作速率。然后将时间和单位时间的工作量相乘来估算工作量。我们调查的主要发现是，服务前和服务后工作占总工作量的很大一部分。服务前和服务后工作占总工作量的典型百分比范围分别为：影像服务为26%，评估与管理服务为33%，医院住院环境中进行的侵入性服务为46%。
