Cardiology 2013

Alternate Journal: Pediatrics

ISSN: 1098-4275 (Electronic)

0031-4005 (Linking)

DOI: 10.1542/peds.2012-0043

Accession Number: 23339229

Keywords: Adolescent

Boston

Cardiac Catheterization/adverse effects/*classification/*statistics & numerical

data

Cardiology/*statistics & numerical data

Child

Child, Preschool

Current Procedural Terminology

Fee Schedules/classification/statistics & numerical data

Female

Heart Defects, Congenital/*classification/diagnosis/therapy

Hospital Information Systems

Humans

Infant

Infant, Newborn

Male

Medicare/statistics & numerical data

Pediatrics/*statistics & numerical data

Probability

Radiation Dosage

Radiology, Interventional/classification/statistics & numerical data

*Relative Value Scales

Risk Assessment

Specialization/*statistics & numerical data

Treatment Outcome

United States

Abstract: OBJECTIVE: We sought to determine the relationship between relative value units (RVUs) and intended measures of work in catheterization for congenital heart disease. METHODS: RVU was determined by matching RVU values to Current Procedural Terminology codes generated for cases performed at a single institution. Differences in median case duration, radiation exposure, adverse events, and RVU values by risk category and cases were assessed. Interventional case types were ranked from lowest to highest median RVU value, and correlations with case duration, radiation dose, and a cases-predicted probability of an adverse event were quantified with the Spearman rank correlation coefficient. RESULTS: Between January 2008 and December 2010, 3557 of 4011 cases were identified with an RVU and risk category designation, of which 2982 were assigned a case type. Median RVU values, radiation dose, and case duration increased with procedure risk category. Although all diagnostic cases had similar RVU values (median 10), adverse event rates ranged from 6% to 21% by age group (P < .001). Median RVU values ranged from 9 to 54 with the lowest in diagnostic and biopsy cases and increasing with isolated and then multiple interventions. Among interventional cases, no correlation existed between ranked RVU value and case duration, radiation dose, or adverse event probability (P = .13, P = .62, and P = .43, respectively). CONCLUSIONS: Time, skill, and stress inherent to performing catheterization procedures for congenital heart disease are not captured by measurement of RVU alone.

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