Cardiology 2013 (Full reference info)

Reference Type: Journal Article
Record Number: 782Author: Bergersen, L., Gauvreau, K., McElhinney, D., Fenwick, S., Kirshner, D., Harding, J., Hickey, P., Mayer, J. and Marshall, A.
Year: 2013
Title: Capture of complexity of specialty care in pediatric cardiology by work RVU measures
Journal: Pediatrics
Volume: 131
Issue: 2
Pages: 258-67
Date: Feb
Short Title: Capture of complexity of specialty care in pediatric cardiology by work RVU measures
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.
Notes: Bergersen, Lisa
Gauvreau, Kimberlee
McElhinney, Doff
Fenwick, Sandra
Kirshner, David
Harding, Julie
Hickey, Patricia
Mayer, John
Marshall, Audrey
eng
Research Support, Non-U.S. Gov’t
2013/01/23 06:00
Pediatrics. 2013 Feb;131(2):258-67. doi: 10.1542/peds.2012-0043. Epub 2013 Jan 21.
URL: http://www.ncbi.nlm.nih.gov/pubmed/23339229
Author Address: Department of Cardiology, The Children’s Hospital, 300 Longwood Ave, Boston, MA, USA. lisa.bergersen@cardio.chboston.org

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