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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >RVUs and DRGs: Do They Fairly Reimburse Physicians and Hospitals and Incentivize Improved Care?
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RVUs and DRGs: Do They Fairly Reimburse Physicians and Hospitals and Incentivize Improved Care?

机译：RVU和DRG：他们是否公平地向内科医生和医院报销并激励改善护理？

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摘要

In 1989, Congress enacted the Omnibus Budget Reconciliation Act, which authorized the Health Care Financing Administration to adopt the use of relative value units (RVUs) as the basis for Medicare and Medicaid reimbursement to physicians. Each RVU is related to the complexity of the services by a defined current procedural terminology (CPT) code, and each has 3 components: (1) physician work RVUs account for the time spent, the cognitive and technical skills needed, and the overall difficulty involved in providing a service or performing a procedure; (2) practice expense RVUs account for nonphysician clinical staff time, medical supplies, and equipment used to maintain and run the facility where the medical encounter occurs; and (3) professional liability RVUs account for the cost of malpractice insurance. Congress assigns a dollar value to an RVU as part of its annual budget process. The geographic differences in costs across the United States are equalized by a geographic practice cost index applied to each RVU. Over time, the use of RVUs has become the reimbursement basis for many private health insurance carriers and for Medicaid and Medicare and has been used as a surrogate measure of physician productivity; it is of paramount importance that the relative value of a physician's work be accurately reflected by the RVUs generated, especially when comparing physicians' work across specialties.
机译：1989年，国会颁布了《综合预算和解法》，授权卫生保健筹资管理局采用相对价值单位（RVU）作为向医生提供医疗保险和医疗补助的基础。每个RVU都通过已定义的当前过程术语（CPT）代码与服务的复杂性相关，并且每个RVU都包含3个组成部分：（1）医生工作RVU负责花费的时间，所需的认知和技术技能以及总体难度参与提供服务或执行程序; （2）实习费用RVU占用非医师的临床人员时间，医疗用品以及用于维护和运行发生医疗事故的设施的设备; （3）职业责任RVU承担了医疗事故保险的费用。国会将RVU的美元价值作为其年度预算流程的一部分。美国各地域成本的地域差异由适用于每个RVU的地域实践成本指数所平均。随着时间的流逝，RVU的使用已成为许多私人健康保险公司以及Medicaid和Medicare的报销基础，并已被用作衡量医生生产率的替代手段。至关重要的是，所生成的RVU可以准确反映出医生工作的相对价值，尤其是在跨专业比较医生工作时。

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