Comparison of work and time estimates by chiropractic physicians with those of medical and osteopathic providers.
BACKGROUND: Resource-based relative value scales (RBRVS) have become a standard method for identifying costs and determining reimbursement for physician services. Development of RBRVS systems and methods are reviewed, and the RBRVS concept of physician 'work' is defined. OBJECTIVE: Results of work a...
| Publicado en: | Journal of Manipulative & Physiological Therapeutics Vol. 22; no. 5; pp. 280 - 292 |
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| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Jun99
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107206274&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107206274 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01614754 8GE jtl: Journal of Manipulative & Physiological Therapeutics issn: 01614754 maglogo: N pubinfo: dt: Jun99 vid: 22 iid: 5 pid: 1265 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 107206274 107206274 1999055026 10.1016/s0161-4754(99)70060-6 NLM10395430 107206274 ppf: 280 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: C tig: atl: Comparison of work and time estimates by chiropractic physicians with those of medical and osteopathic providers. aug: au: Hess, Jennifer A. Mootz, Robert D. affil: Graduate student, University of Iowa, Department of Biomedical Engineering, Iowa City, Iowa. sug: subj: Chiropractic Task Performance and Analysis Osteopathy Work Specialties, Medical Time Reimbursement Mechanisms Funding Source Survey Research Vignettes Current Procedural Terminology Random Sample Questionnaires Descriptive Statistics Regression Comparative Studies Confidence Intervals Human ab: BACKGROUND: Resource-based relative value scales (RBRVS) have become a standard method for identifying costs and determining reimbursement for physician services. Development of RBRVS systems and methods are reviewed, and the RBRVS concept of physician 'work' is defined. OBJECTIVE: Results of work and time inputs from chiropractic physicians are compared with those reported by osteopathic and medical specialties. Last, implications for reimbursement of chiropractic fee services are discussed. METHODS: Total work, intraservice work, and time inputs for clinical vignettes reported by chiropractic, osteopathic, and medical physicians are compared. Data for chiropractic work and time reports were drawn from a national random sample of chiropractors conducted as part of a 1997 workers' compensation chiropractic fee schedule development project. Medical and osteopathic inputs were drawn from RBRVS research conducted at Harvard University under a federal contract reported in 1990. Both data sets used the same or similar clinical vignettes and similar methods. Comparisons of work and time inputs are made for clinical vignettes to assess whether work reported by chiropractors is of similar magnitude and variability as work reported by other specialties. RESULTS: Chiropractic inputs for vignettes related to evaluation and management services are similar to those reported by medical specialists and osteopathic physicians. The range of variation between chiropractic work input and other specialties is of similar magnitude to that within other specialties. Chiropractors report greater work input for radiologic interpretation and lower work input for manipulation services. CONCLUSIONS: Chiropractors seem to perform similar total 'work' for evaluation and management services as other specialties. No basis exists for excluding chiropractors from using evaluation and management codes for reimbursement purposes on grounds of dissimilar physician time or work estimates. Greater work input by chiropractors in radiology interpretation may be related to a greater importance placed on findings in care planning. Consistently higher reports for osteopathic work input on manipulation are likely attributable to differences in reference vignettes used in the respective populations. Research with a common reference vignette used for manipulation providers is recommended, as is development of a single generic approach to coding for manipulation services. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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