Petranovich Christine, Johnson Abigail, Smith-Paine Julia, Tlustos Sarah J, Baum Katherine T
Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Rehabilitation Medicine, Children's Hospital Colorado, Aurora, CO, USA.
Child Neuropsychol. 2023 Apr;29(3):445-456. doi: 10.1080/09297049.2022.2097652. Epub 2022 Jul 14.
Professional challenges have been documented in broad surveys of neuropsychologists. While previous surveyors have included pediatric neuropsychologists, few, if any, have specifically examined practices among those who primarily work in pediatric inpatient rehabilitation settings. Therefore, the aim of this study was to survey neuropsychologists in this setting. Thirty neuropsychologists from the U.S. and one from Canada that work in inpatient pediatric rehabilitation participated in an online survey. Most respondents (83.3%) billed for their inpatient time. Sixty-four percent indicated that payor type (private vs. public) affected services a moderate amount to a lot; this was primarily due to payor's influence on length of stay. Most providers had productivity expectations (66.7%). Among those that had productivity expectations, three-quarters used "hours billed;" 37.5% were solely or additionally tracked by relative value units (RVUs). The majority of respondents conducted some type of clinical data collection, usually for research purposes. With respect to professional identity, most respondents indicated positivity about their role. The top challenges endorsed were related to workload/ability to meet the patients' needs and billing/productivity. Issues related to billing and payor may influence aspects of pediatric inpatient rehabilitation neuropsychological care. Managing challenges related to billing and the time demands associated with providing inpatient services were top concerns for many respondents. Most sites surveyed were involved in data collection, usually for research purposes; increased data collection efforts are needed to aid with program development and evaluation and to demonstrate the added value of neuropsychological services from a patient care perspective.
在对神经心理学家的广泛调查中记录了专业挑战。虽然之前的调查对象包括儿科神经心理学家，但几乎没有（如果有的话）专门研究主要在儿科住院康复环境中工作的人员的实践情况。因此，本研究的目的是对该环境中的神经心理学家进行调查。来自美国的30名和来自加拿大的1名在儿科住院康复机构工作的神经心理学家参与了一项在线调查。大多数受访者（83.3%）为其住院时间计费。64%的人表示付款方类型（私立与公立）对服务有中度到很大程度的影响；这主要是由于付款方对住院时间的影响。大多数提供者有生产力期望（66.7%）。在有生产力期望的人中，四分之三使用“计费小时数”；37.5%仅通过或额外通过相对价值单位（RVU）进行跟踪。大多数受访者进行了某种类型的临床数据收集，通常是出于研究目的。关于职业身份，大多数受访者对自己的角色表示积极态度。认可的首要挑战与工作量/满足患者需求的能力以及计费/生产力有关。与计费和付款方相关的问题可能会影响儿科住院康复神经心理护理的各个方面。管理与计费以及提供住院服务相关的时间需求方面的挑战是许多受访者最关心的问题。大多数接受调查的机构都参与了数据收集，通常是出于研究目的；需要加大数据收集力度，以协助项目开发和评估，并从患者护理角度证明神经心理服务的附加价值。
