A method for estimating the preservice and postservice work of physicians' services
D. Dunn, W. C. Hsiao, T. R. Ketcham and P. Braun
Department of Health Policy and Management, Harvard University School of Public Health, Boston, MA 02115.
The goal of the Resource-Based Relative Value Scale is to measure the
resource costs of physicians' services, or, more centrally, the physicians'
total work. This article describes the estimation of relative values for
physicians' work before and after the performance of a service (preservice
and postservice work). For methodological and practical reasons, we could
not obtain direct ratings of preservice and postservice work except for a
few services. We therefore developed a systematic process to estimate
preservice and postservice time and rate of work per unit of time. Then
time and work per unit of time were multiplied to estimate work. The major
finding of our investigation is that preservice and postservice work make
up a substantial portion of total work. The typical percentages of total
work accounted for by preservice and postservice work range from 26% and
33% for imaging services and evaluation and management services,
respectively, to 46% for invasive services performed in a hospital
inpatient setting.
