Braun P, Yntema D B, Dunn D, DeNicola M, Ketcham T, Verrilli D, Hsiao W C
Department of Health Policy and Management, Harvard University School of Public Health, Boston, MA 02115.
JAMA. 1988 Oct 28;260(16):2390-6.
This article describes methods used to combine into a common scale resource-based relative values from separate specialties. The key to producing a common scale is identifying pairs ("links") of services from different specialties that require approximately equal amounts of intraservice work. We distinguished two kinds of pairs of link services, those judged to be the same and those judged to be equivalent, usually within a narrow category of medical activity. Working with a cross-specialty panel of physicians and with data on time factors from a national survey, we selected sufficient links to connect each specialty to others by at least four links. We then used the weighted least-squares method to locate all the links optimally on a single, common scale. Analyses of the accuracy of this scale showed that the typical disagreement between specialties about where to locate the intraservice work of a given service was only 7%. Other analyses showed that the accuracy of the common scale was not sensitive to different classes of links.
本文介绍了将来自不同专业的基于资源的相对价值整合为一个通用量表的方法。生成通用量表的关键在于识别不同专业中需要大致等量内部服务工作的服务对（“链接”）。我们区分了两种链接服务对，即通常在狭义医疗活动类别内被判定为相同的和被判定为等效的。与跨专业医生小组合作并利用全国调查中的时间因素数据，我们选择了足够的链接，以便通过至少四个链接将每个专业与其他专业相连。然后，我们使用加权最小二乘法在单一通用量表上对所有链接进行最优定位。对该量表准确性的分析表明，各专业在给定服务内部服务工作定位上的典型分歧仅为7%。其他分析表明，通用量表的准确性对不同类别的链接不敏感。
