Society for Clinical Vascular Surgery. Annual Meeting. Naples, Florida (USA), 1997/03/12.
Two major flaws have been previously identified in the resource-based relative value scale (RBRVS) : (1) inaccurate estimation of physician work effort ; and (2) RBRVS compression, which results in undervaluation of major surgical procedures.
The impact of RBRVS for physicians treating patients with ruptured abdominal aortic aneurysms (RAAAs) has not been previously reported and is important owing to the severity of the illness, the potential to quantitate actual work effort, and the high percentage of these patients covered by Medicare.
All patients were studied who underwent surgery for RAAAs during a 5-year period encompassing the implementation of RBRVS.
Analysis included all physician services including vascular surgeons, anesthesiologists, and all other medical specialists.
Total work effort was quantitated for each specialty in minutes/patient.
The financial data were obtained by reviewing all professional bills and reimbursements.
Cost of service was calculated to include physician compensation, practice overhead costs, and malpractice expenses.
In all, 84 patients underwent repair of a RAAA with a mortality rate of 42%. Medicare was the primary insurance for 87% of patients.
The cost of service exceeded the reimbursement by 50% for vascular surgeons, resulting in an average loss of $1,593/patient.
Actual operative time represented only 24% of total surgical work effort. (...)
Mots-clés Pascal : Anévrysme, Aorte abdominale, Rupture, Traitement, Médecin, Analyse coût, Economie santé, Homme, Etats Unis, Amérique du Nord, Amérique, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Aorte pathologie, Artère pathologie, Remboursement
Mots-clés Pascal anglais : Aneurysm, Abdominal aorta, Rupture, Treatment, Physician, Cost analysis, Health economy, Human, United States, North America, America, Cardiovascular disease, Vascular disease, Aortic disease, Arterial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0515893
Code Inist : 002B25F. Création : 13/02/1998.