PDF(Pubmed)
Abstract：
UNASSIGNED: China\'s National Health Service Items Standard (NHSIS) establishes a relative value system and plays an important role in pricing. However, there are few empirical evaluations of the objectivity of the NHSIS-estimated relative value.
UNASSIGNED: This paper presents a comparison between physician work relative value units (wRVUs) estimates for 70 common surgical procedures from NHSIS and those from the U.S. Medicare Physician Fee Schedule (MPFS). We defined the ratio of the wRVUs for sample procedures to the benchmark procedure (inguinal hernia repair) as a standardized relative value unit (SRVU), which was used to standardize the data for both schedules. We examined the variances in the ranking and quantification of SRVUs across specialties and procedures, as well as how SRVUs impact procedure reimbursement prices between the two schedules.
UNASSIGNED: There was no systematic difference between MHSIS-estimated SRVUs and MPFS-estimated, but the dispersion of MPFS-estimated SRVU was greater than that of MHSIS-estimated, and the discrepancies increased with surgical risk and technical complexity. The discrepancies of SRVUs were significant in cardiothoracic procedures. Additionally, whether SRVUs were based on MPFS or MHSIS, there was a positive association between them and payment prices. However, in terms of the impact of SRVUs on payment pricing, the NHSIS system was lower than the MPFS system.
UNASSIGNED: China has made incremental progress in estimating the relative value of healthcare services, but there are shortcomings in valuation methods and their impact on pricing. The modular assessment method should be considered as a component to optimize reform.
UNASSIGNED: This paper presents a comparison between physician work relative value units (wRVUs) estimates for 70 common surgical procedures from NHSIS and those from the U.S. Medicare Physician Fee Schedule (MPFS). We defined the ratio of the wRVUs for sample procedures to the benchmark procedure (inguinal hernia repair) as a standardized relative value unit (SRVU), which was used to standardize the data for both schedules. We examined the variances in the ranking and quantification of SRVUs across specialties and procedures, as well as how SRVUs impact procedure reimbursement prices between the two schedules.
UNASSIGNED: There was no systematic difference between MHSIS-estimated SRVUs and MPFS-estimated, but the dispersion of MPFS-estimated SRVU was greater than that of MHSIS-estimated, and the discrepancies increased with surgical risk and technical complexity. The discrepancies of SRVUs were significant in cardiothoracic procedures. Additionally, whether SRVUs were based on MPFS or MHSIS, there was a positive association between them and payment prices. However, in terms of the impact of SRVUs on payment pricing, the NHSIS system was lower than the MPFS system.
UNASSIGNED: China has made incremental progress in estimating the relative value of healthcare services, but there are shortcomings in valuation methods and their impact on pricing. The modular assessment method should be considered as a component to optimize reform.
摘要：
■中国国家卫生服务项目标准（NHSIS）建立了相对价值体系，在定价中发挥着重要作用。然而,关于NHSIS估计相对价值的客观性，很少有经验评估。
■本文比较了NHSIS和美国医疗保险医师费用表（MPFS）中70例常见外科手术的医师工作相对价值单位（wRVU）估计值。我们将样本程序的wRVU与基准程序（腹股沟疝修补术）的比率定义为标准化的相对值单位（SRVU）。用于标准化两个时间表的数据。我们检查了不同专业和程序的SRVU的排名和量化差异，以及SRVU如何影响两个时间表之间的程序报销价格。
■MHSIS估计的SRVU和MPFS估计的SRVU之间没有系统差异，但是MPFS估计的SRVU的离差大于MHSIS估计的离差，差异随着手术风险和技术复杂性的增加而增加。在心胸手术中，SRVU的差异显着。此外,SRVU是基于MPFS还是MHSIS，它们与支付价格之间存在正相关关系。然而,就SRVU对支付定价的影响而言，NHSIS系统低于MPFS系统。
■中国在估算医疗服务的相对价值方面取得了进步，但估值方法存在缺陷及其对定价的影响。应将模块化评估方法视为优化改革的组成部分。
■本文比较了NHSIS和美国医疗保险医师费用表（MPFS）中70例常见外科手术的医师工作相对价值单位（wRVU）估计值。我们将样本程序的wRVU与基准程序（腹股沟疝修补术）的比率定义为标准化的相对值单位（SRVU）。用于标准化两个时间表的数据。我们检查了不同专业和程序的SRVU的排名和量化差异，以及SRVU如何影响两个时间表之间的程序报销价格。
■MHSIS估计的SRVU和MPFS估计的SRVU之间没有系统差异，但是MPFS估计的SRVU的离差大于MHSIS估计的离差，差异随着手术风险和技术复杂性的增加而增加。在心胸手术中，SRVU的差异显着。此外,SRVU是基于MPFS还是MHSIS，它们与支付价格之间存在正相关关系。然而,就SRVU对支付定价的影响而言，NHSIS系统低于MPFS系统。
■中国在估算医疗服务的相对价值方面取得了进步，但估值方法存在缺陷及其对定价的影响。应将模块化评估方法视为优化改革的组成部分。
