Correlation of Relative Value Units with Surgical Complexity and Physician Workload in Urology
| Autor: | Case M. Wood, Solomon Hayon, Hung-Jui Tan, Zoe S. Gan, Allison M. Deal, Angela B. Smith, Raj S. Pruthi |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Urologic Diseases
Current Procedural Terminology medicine.medical_specialty Urology medicine.medical_treatment Operative Time 030232 urology & nephrology Efficiency Workload Studentized residual Patient Readmission Cystectomy Correlation 03 medical and health sciences symbols.namesake Postoperative Complications 0302 clinical medicine Physicians Humans Medicine Medical physics Hospital Mortality Relative value business.industry Patient Acuity Regression analysis Relative Value Scales Quality Improvement United States Pearson product-moment correlation coefficient Logistic Models 030220 oncology & carcinogenesis symbols Urologic Surgical Procedures Surgery business |
| Zdroj: | Journal of the American College of Surgeons. 227:S279-S280 |
| ISSN: | 1072-7515 |
| Popis: | OBJECTIVE To define the relationship between urology relative value units (RVUs) and measures of surgical complexity and physician workload. Secondary objectives include: (1) identifying procedures with outlying RVU values for their measures of surgical complexity and workload; and (2) calculating projected RVU values for these procedures. METHODS We obtained surgical case data for 71 urology current procedural terminology (CPT) codes from the 2017 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Pearson correlation coefficients were calculated to measure the association between mean total work RVU and operative time, length of hospital stay, serious adverse events, readmissions, and mortality. We developed a multivariable regression model to predict mean total work RVU from these measures. Studentized residuals were used to identify outlying CPT codes for both bivariable and multivariable regression models, and empirically derived RVU values from complexity and work effort metrics were estimated. RESULTS We analyzed 71 urology CPT codes encompassing 55,068 cases. RVUs correlated well with median length of hospital stay (R = 0.81), median operative time (R = 0.92), serious adverse events (R = 0.83), and readmissions (R = 0.74). RVUs were poorly correlated with mortality (R = 0.34). Outlying procedures identified using the multivariable model were retroperitoneal lymph node dissection (projected +21.09 RVUs), laparoscopic ureteroneocystotomy (projected −12.34 RVUs), and cystectomy with bilateral pelvic lymphadenectomy (projected +9.37 RVUs). CONCLUSION Urology work RVUs correlate more with operative time than other measures of surgical complexity and physician workload. There exist several significant outlying procedures for various work measures. Incorporating objective work data may improve RVU assignments in the future. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|