A Study of Resource Based Relative Value for Pediatric Cardiology
|Keywords:||兒童心臟醫療;資源基礎相對值;作業基礎成本制;pediatric cardiology;resource-based relative value scale;activity-based costing||Issue Date:||2004||Abstract:||
The national insurance bureau is developing resource based relative value scale (RBRVS) as a reimbursement system for medical service in Taiwan. The relative value scale (RVS) is calculated as following: RVS = RVUw+RVUPE+ RVUmalp. Then RVS is converted to amount of money by a conversion factor. The purpose of this study aims to compare the pediatric cardiology work relative value to those of adult cardiology. The procedure time of cardiac catheterization and angiography in children and infants were measured in patients admitted to this hospital. The costs of the above procedures were also calculated using activity-based costing (ABC). The reimbursement for the above procedure from the national insurance bureau was used to compared the costs of the procedure in patients with different ages and different complexity. Questionnares regarding the procedure time and relative value scale in 21 current procedure terminologies in children were surveyed among pediatric cardiologists. The results of the studies showed the mean procedure time of cardiac catheterization and angiography in infants were significantly longer than that in older children and adults. The more complexity of the heart disease, the longer procedure time will be. The cost of the procedure incurred is inversely related to mean age of the patients and is positively related to complexity of heart disease. The ratio of reimbursement to cost is far below 40%, if the diagnosis is complex heart disease. The results of guestionnare are similar to this study and could be used to support the results of the current study. All participants agreed that the relative value for pediatric cardiology work is significantly higher than those of abult cardiology. The RBRVS which will be implemented in Taiwan should be carefully reevaluated since there is no malpractice insurance RVS and the reimbursements for pediatric cardiology are far below the costs. Therefore, it is concluded that age and complexity in diagnosis should be used as a modifier in the calculation of RVS, particulary a younger age is frequently associated with more difficulties in procedures. The costs estimated with ABC are significantly higher than reimbursements.
|Appears in Collections:||會計學系|
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.