When Benchmarks Fail Us: A Case Study in Cytoreductive Surgery

期刊论文
发表日期：

2024年10月26日

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Varun V. Bansal,
Hunter D. D. Witmer,
Christopher P. Childers,
David G. Su,
Kiran K. Turaga,
Abhineet Uppal,
Alex Kim,
Alexandra Gangi,
Alissa Greenbaum,
Amanda Arrington,
Ana Gleisner,
Anai kothari,
Anand Govindrajan,
Andrew Blakely,
Andrew Lowy,
Anthony Villano,
Antoine Bouchard-Fortier,
Armando Sardi,
Avinoam Nevler,
Benjamin Powers,
Beth Helmink,
Brian Badgwell,
Byrne Lee,
Carlos Chan,
Carrie Luu,
Catalina Mosquera,
Charles Staley,
Chukwuemeka Ihemelandu,
Colette Pameijer,
Colin Court,
Conor O’Neill,
Dan Blazer,
Daniel Abbott,
Daniel Labow,
Daniel Milgrom,
Daniel Tuvin,
Darryl Schuitevoerder,
David Bartlett,
David Kwon,
Deepa Magge,
Divya Sood,
Edward Levine,
Emmanuel Gabriel,
Erin Ward,
Fabian Johnston,
Fadi Dahdaleh,
Farin Amersi,
Filip Bednar,
Garrett Nash,
Gary Mann,
George Salti,
Georgios Georgakis,
Georgios Karagkounis,
Giorgos Karakousis,
Grace Mak,
Haejin In,
Harveshp Mogal,
Hatem Halabi,
Ian Solsky,
Ioannis Konstantinidis,
Ira Leeds,
James Cusack,
James Fleshman,
Jason Foster,
Jeffreey Sussman,
Jeffrey Sutton,
Jennifer Keller,
Jeremiah Deneve,
Jeremy Davis,
Jeremy Sharib,
Jesus Esquivel,
Joel Baumgartner,
John Kunstman,
John Miura,
Jonathan Greer,
Jordan Cloyd,
Joseph Kim,
Joshua Mammen,
Joshua Winer,
Jula Veerapong,
Kamran Idrees,
Kimberly Kopecky,
Konstantin Votanopoulos,
Konstantinos Chouliaras,
Laura Lambert,
Leopoldo Fernandez,
Lindy Davis,
Lloyd Mack,
Mohammad Haroon Asif Choudry,
Maheshwari Senthil,
Marcovalerio Melis,
Maria Russell,
Mary Garland Kledzik,
Mautin Barry-Hundeyin,
Mazin Al-Kasspooles,
Mecker Geraldine Möller,
Mehraneh Jafari,
Melanie Ongchin,
Michael Kluger,
Michael White,
Mikael Soucisse,
Mio Kitano,
Mohamed Adam,
Mustafa Raoof,
Nabil Wasif,
Nancy Baxter,
Nader Hanna,
Nelya Melnitchouk,
Nikolaos Dallas,
Niraj Gusani,
Oliver Eng,
Patricio Polanco,
Patrick Wagner,
Paul H. Sugarbaker,
Paul Mansfield,
Prakash Pandalai,
Randall Zuckerman,
Ravi Chokshi,
Rebecca Wiatrek,
Richard Alexander,
Richard Berri,
Richard Hoehn,
Richard Royal,
Robert Barone,
Robert Sticca,
Rupen Shah,
Ryan Merkow,
Sabha Ganai,
Sam Pappas,
Sameer Patel,
Samer Naffouje,
Sanjay Bagaria,
Scott Sherman,
Sean Dineen,
Sepideh Gholami,
Seth Concors,
Sherif Abdel-Misih,
Stephanie Greco,
Steven Ahrendt,
TClark Gamblin,
Thinzar Lwin,
Timothy Kennedy,
Trang Nguyen,
Travis Grotz,
Ugwuji Maduekwe,
Umut Sarpel,
Vadim Gushchin,
Vivian Strong,
Wilbur Bo Bowne,
William Morano,
Xavier Keutgen,
Yanghee Woo

摘要

Introduction

Relative Value Units (RVUs) are utilized to measure physician work effort and create national benchmarks. Physicians are often measured against national benchmarks to determine compensation. Using a case study in cytoreductive surgery, we explored variability in coding that can impact national benchmarks.

Methods

A survey was conducted amongst surgeons in the peritoneal surface malignancies consortium (PSM). Data was collected on clinical experience, clinical full time equivalent, wRVUS and institutional coding practice.

Results

Coding of the same procedure resulted in significantly varying RVUs (IQR 60-101) across institutions. Higher volume (> 50% practice) appeared to have better coding practices with higher wRVU/case (Median 102 vs 62, p = 0.04).

Conclusions

There is significant variability in the measurement of similar effort across institutions due to coding variability. Such variability creates flaws in measurement necessary for benchmarks.