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Value Scale (value + scale)
Kinds of Value Scale Selected AbstractsDevelopment and Implementation of a Relative Value Scale for Teaching in Emergency Medicine: The Teaching Value UnitACADEMIC EMERGENCY MEDICINE, Issue 8 2003Naghma S. Khan MD Abstract Relative value units exist for measuring clinical productivity. Limited objective measures exist, however, for nonclinical activities, specifically teaching. Objective: To develop an objective measure of teaching productivity linked to a performance-based incentive plan. Methods: Teaching goals and objectives were identified before the 1998,1999 academic year. Teaching value units (TVUs), objective measures for quantifying teaching activities, were developed and assigned based on an estimation of time needed to complete each activity and weighted for importance to the teaching mission. Each physician was allocated teaching time based on past performance and future goals. Targeted TVUs necessary to meet expectations were proportionate to allocated teaching time. Teaching productivity was defined as a percentage of targeted TVUs achieved. Incentive dollars for teaching were distributed based on percentage of targeted TVUs achieved, weighted individually for teaching load. Results: Teaching productivity was evaluated over a three-year period. In year 1, mean TVUs allocated/physician were 181 units (range 25 to 449). Four of 18 physicians (22%) met expectations. The mean individual TVUs achieved were 54% of expected (range 0% to 114%). By year 3, mean TVUs allocated/physician were 179 (range 45 to 629). Twelve of 22 physicians (55%) met expectations. The mean individual TVUs achieved were 82% of expected (range 11% to 146%). Between year 1 and year 3, group productivity increased from 73% to 88%, and mean individual productivity increased from 54% to 82% (p = 0.01). Conclusions: The development of a TVU-based system enabled objective quantification and monitoring of a broad range of teaching activities. The TVU-based system linked to an incentive plan helped to increase individual and group teaching productivity. [source] Pilot study comparing patients' valuation of health-care services with Medicare's relative value unitsHEALTH EXPECTATIONS, Issue 4 2008Steven J. Kravet MD Abstract Background and aims, Physician reimbursement for services and thus income are largely determined by the Medicare Resource-Based Relative Value Scale. Patients' assessment of the value of physician services has never been considered in the calculation. This study sought to compare patients' valuation of health-care services to Medicare's relative value unit (RVU) assessments and to discover patients' perceptions about the relative differences in incomes across physician specialties. Design, Cross-sectional survey. Participants and setting, Individuals in select outpatient waiting areas at Johns Hopkins Bayview Medical Center. Methods, Data collection included the use of a visual analog ,value scale' wherein participants assigned value to 10 specific physician-dependent health-care services. Informants were also asked to estimate the annualized incomes of physicians in specialties related to the abovementioned services. Comparisons of (i) the ,patient valuation RVUs' with actual Medicare RVUs, and (ii) patients' estimations of physician income with actual income were explored using t -tests. Outcomes, Of the 206 eligible individuals, 186 (90%) agreed to participate. Participants assigned a significantly higher mean value to 7 of the 10 services compared with Medicare RVUs (P < 0.001) and the range in values assigned by participants was much smaller than Medicare's (a factor of 2 vs. 22). With the exception of primary care, respondents estimated that physicians earn significantly less than their actual income (all P < 0.001) and the differential across specialties was thought to be much smaller (estimate: $88 225, actual: $146 769). Conclusion, In this pilot study, patients' estimations of the value health-care services were markedly different from the Medicare RVU system. Mechanisms for incorporating patients' valuation of services rendered by physicians may be warranted. [source] Rural-Urban Differences in Health Risks, Resource Use and Expenditures Within Three State Medicaid Programs: Implications for Medicaid Managed CareTHE JOURNAL OF RURAL HEALTH, Issue 1 2002Janet M. Bronstein Ph.D. This study uses Medicaid claims data for income-eligible enrollees in California, Georgia and Mississippi to compare expenditures, resource usage and health risks between residents of rural and urban areas of the states. Resource use is measured using the Resource Based Relative Value Scale (RBRVS) system for professional services, hospital days and outpatient facility visits; it also is valued at private insurance reimbursement rates for the states. Health risks are measured using the diagnosis-based Adjusted Clinical Group system. Resource use is compared on a risk-adjusted basis with the use of urban Medicaid enrollees as the benchmark. We find that actual expenditures for rural care users are lower than for urban care users. However, because the proportion of Medicaid enrollees who use care is higher in rural than in urban areas in all three states, expenditures per rural enrollee are not consistently lower. Case mix is more resource intensive for rural compared to urban residents in all three states. Although resource usage is not systematically lower owerall for rural enrollees, on a risk-adjusted basis they tend to use less hospital resources than urban enrollees. Capitation rates based on historical per enrollee expenditures would not appear to under-reimburse managed care organizations for the care of rural as opposed to urban residents in the study states. [source] Estimating nurses' workload using the Diagnosis Procedure Combination in JapanINTERNATIONAL NURSING REVIEW, Issue 3 2008Y. Kamijo rn Aim:, To examine the methods used to estimate nurse staffing levels in acute care settings with Diagnosis Related Groups, which in Japan are called the Diagnosis Procedure Combination (DPC). Methods:, For estimating staffing requirements, the study used four DPC groups: (1) acute or recurrent myocardial infarction (AMI) with stenting, (2) angina pectoris with coronary artery bypass grafting (CABG), (3) sub-arachnoid haemorrhage (SAH) with clipping surgery, and (4) cerebral infarction with carotid endarterectomy (CEA). Registered nurses with more than 3-year nursing experience in nine university hospitals in the Tokyo metropolitan area completed self-report questionnaires in order to obtain nursing care time and care intensity per each DPC. The concordance rate was measured by Kendall's coefficient of concordance. The relationship between the care time and the care intensity was examined by a time series graph per DPC. Care intensity consisted of professional judgement, mental effort for helping patients, professional skill, physical effort for providing activities of daily living support, and nurse stress, based on the Hsiao and colleagues' model of resource-based relative value scale. Results:, Twenty-five nurses in nine university hospitals answered for a hypothetical typical patient with AMI and with CABG, and 28 nurses in nine university hospitals answered for a hypothetical typical patient with SAH and with CEA. Kendall's coefficient of concordance was 0.896 for AMI, 0.855 for CABG, 0.848 for SAH, 0.854 for CEA. The time series data of the care time and the care intensity items showed different patterns for each DPC. Conclusion:, The DPC for cardiovascular and cerebral surgical procedures can be used for estimating nurses' workload. [source] New Shade Guide for Evaluation of Tooth Whitening,Colorimetric StudyJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2007RADE D. PARAVINA DDS ABSTRACT Statement of the Problem:, Available shade guides lack colorimetric uniformity, which compromises the validity of visual evaluation of tooth whitening efficacy. Purpose:, The objective of this study was to perform a colorimetric analysis of a new shade guide designed primarily for the visual evaluation of tooth whitening efficacy and to compare this shade guide with two commercial shade guides. Materials and Methods:, Color ranges and color distribution of three shade guides (prototype of the new Vita Bleachedguide 3D-Master [BG, Vita Zahnfabrik, Bad Säckingen, Germany], value scale of Vitapan Classical [VC, Vita], and color-ordered Trubyte Bioform porcelain shade guide [TB, Dentsply International, York, PA, USA]) were analyzed (N=3). A circular area (d=1.7 mm) on the middle of the labial surface of the tab, excluding the cervical portion, was measured with a spectroradiometer (D65, 2). Whiteness and yellowness indices were computed. Data were analyzed by analysis of variance and Fisher's PLSD test at a 0.05 level of significance. Results:, The range of color difference (,E*) from the lightest to the darkest tab was 33.8 (BG), 17.1 (VC), and 23.2 (TB). Mean values of ,E* among pairs of adjacent tabs were 3.0 (BG), 4.2 (VC), and 3.3 (TB). BG exhibited the highest R2 values between color coordinate pairs and between whiteness and yellowness indices with the respective color coordinates. Conclusions:, BG exhibited the widest color range and had the most consistent color distribution as compared with the two commercial products. Extension of the lightness range of BG toward higher L* values (bleach shades) was confirmed. CLINICAL SIGNIFICANCE A dental shade guide that is colorimetrically uniform might increase the reliability of visual comparisons of tooth whitening efficacy, whereas the inclusion of realistic bleaching shades in the shade guide will complement contemporary esthetic dentistry. (J Esthet Restor Dent 19:276,283, 2007) [source] Personal impact of disability in osteoarthritis: patient, professional and public valuesMUSCULOSKELETAL CARE, Issue 3 2006Vikki Wylde BSc Abstract Background:,Osteoarthritis (OA) is a leading cause of disability. Numerous tools are available to assess this, but they fail to place a patient value upon disability. In rheumatoid arthritis, research has shown patients have different importance values for similar disabilities, and these individual values can be used to weight disability levels, creating a measure of personal impact. Objectives:,Firstly, to determine if the Health Assessment Questionnaire (HAQ) can be used as the basis for an importance value scale by assessing if it includes activities considered important by OA patients. Secondly, to determine if the weights used for the value scale should be based on population, healthcare professional or patient values. Method:,Twenty-five OA patients, 25 healthy controls and 25 healthcare professionals rated the importance of the items on the HAQ and shortened Modified HAQ (MHAQ). Prior to completing the HAQ, patients generated a list of activities that were important to them. Result:,The HAQ contained 69% of items that patients considered important. No items were consistently deemed unimportant by patients. There was low agreement within and between groups about the importance of the items on the HAQ and MHAQ. Conclusion:,The HAQ is a suitable basis for a value scale for an OA disability impact score. Importance values for function differed for patients, healthcare professionals and the general population; therefore individual patient weightings need to be used. Further work is under way to validate a measure of the personal impact of disability in patients with lower limb OA. Copyright © 2006 John Wiley & Sons, Ltd. [source] A survey of clinical productivity and current procedural terminology (CPT) coding patterns of pediatric hematologist/oncologistsPEDIATRIC BLOOD & CANCER, Issue 2 2004Timothy C. Griffin MD Abstract Background Subspecialty-specific normative values for clinical productivity of practicing pediatric hematologist/oncologists have not been well established. This information could be a useful adjunct in administrative decision-making in areas such as necessary levels of physician staffing and development of compensation plans. Methods Current procedural terminology (CPT) coding information was obtained from 27 pediatric hematology/oncology groups. Clinical productivity was assessed by overall number of patient encounters and the total number of physician work relative value units (RVU) as defined by the resource-based relative value scale. The average physician productivity within each individual program was calculated. To determine uniformity of CPT coding, an additional survey solicited mock patient encounter documentation and CPT coding for a simple clinical vignette. Results A broad range of clinical productivity was observed for both numbers of patient encounters and RVU. Evaluation of the CPT coding data of the surveyed groups revealed differences in usage of certain evaluation and management (E/M) codes and procedural and specimen interpretation codes. Within individual categories of E/M service codes, a wide variation in assigned CPT code levels was also observed. This observation was supported by differences in the E/M coding for the clinical vignette. Conclusions Assessment and tracking of physician productivity can provide useful information for the administrative management of pediatric hematology/oncology programs. Caution must be exercised, however, when making productivity comparisons with other subspecialties or even between pediatric hematology/oncology programs. Such comparisons should take into account the number of patient encounters, characteristics of E/M coding patterns, the use of physician extenders, as well as overall RVU production. © 2004 Wiley-Liss, Inc. [source] Value priorities of HRD scholars and practitionersINTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 4 2002Reid Bates This study represents an initial effort to identify and measure a set of values that reflect the goals that human resource development (HRD) scholars and practitioners believe HRD should strive to achieve. Six values reflecting two value facets (locus of HRD influence and HRD outcomes) and a seventh value that relates to a perceived normative component inherent of HRD activity were identified and measured. Results indicated the value scales measured individual value priorities of HRD scholars and practitioners, and that the structure of these value priorities varied as a function of individual differences. Suggestions for future research are offered. [source] Different value scales between frequency-doubling technique and standard threshold perimetryACTA OPHTHALMOLOGICA, Issue S232 2000M. Iester No abstract is available for this article. [source] | ||||||||||