The intensity of physicians'work in patient visits.
Background Clinicians use visit codes to bill for services involving the evaluation of patients and the management of their care.
The existing guidelines for coding and documenting these services, as well as proposed revisions, have been criticized as complex, clinically irrelevant, and costly.
We investigated whether easily measured characteristics of physician-patient visits accurately reflect differences in the amount of work performed.
Such characteristics might provide the basis for a simple and equitable physician-payment scheme.
Methods We collected information about the amount of physicians'work, the time spent in encounters with patients, and characteristics of patients and visits for 19,143 physician-patient visits in the practices of 339 urologists, rheumatologists, and general internists.
Physicians recorded the actual time involved in evaluating the patient and managing his or her care during each visit and estimated the work involved in relation to a standardized, hypothetical visit.
We used multivariate linear regression to identify factors related to differences in the total amount of work and to calculate work and work intensity (work per minute) for different types of visits.
Results The duration of the face-to-face encounter with the patient or family (encounter time) was strongly predictive of the total amount of work.
Total work, however, did not increase in direct proportion to encounter time. (...)
Mots-clés Pascal : Etats Unis, Amérique du Nord, Amérique, Epidémiologie, Homme, Personnel sanitaire, Médecin, Pratique professionnelle, Qualité, Durée, Consultation, Relation médecin malade, Evaluation
Mots-clés Pascal anglais : United States, North America, America, Epidemiology, Human, Health staff, Physician, Professional practice, Quality, Duration, Consultation, Physician patient relation, Evaluation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0403889
Code Inist : 002B30A05. Création : 22/03/2000.