Arman Kishan , Sarah I. Goldfarb , Kiyanna Thomas , Sanjay Kubsad , Ansh Kishan , Jacob D. Mikula , Henry Maxwell Fox , Umasuthan Srikumaran
{"title":"在化脓性翻修全肩关节置换术中使用工作相对值单位比较医生报酬","authors":"Arman Kishan , Sarah I. Goldfarb , Kiyanna Thomas , Sanjay Kubsad , Ansh Kishan , Jacob D. Mikula , Henry Maxwell Fox , Umasuthan Srikumaran","doi":"10.1016/j.jorep.2024.100471","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Revision total shoulder arthroplasty (TSA) for prosthetic joint infection (herein, “septic revision TSA”) requires more time and resources compared with revision in the absence of infection (“aseptic revision TSA”). Physician compensation should accurately reflect this greater burden. In this study, we assessed whether physician compensation for septic revision TSA is proportionate to that for aseptic revision TSA.</p></div><div><h3>Methods</h3><p>The National Surgical Quality Improvement Program database was queried from 2006 to 2021 to identify cases of aseptic and septic revision TSA. Work relative value units (wRVUs), operative time, wRVUs per minute, and compensation per hour were compared between aseptic and septic cases. Univariate and multivariate analyses were conducted to assess wRVU adequacy for septic revision TSA. The wRVU-to-dollar conversion factor was obtained from the US Centers for Medicare & Medicaid Services, and wRVU dollar valuations were calculated. P values < 0.05 were considered significant.</p></div><div><h3>Results</h3><p>Mean (± standard deviation) operative times were 125 ± 62 (range, 21–695) minutes for aseptic revision TSA and 135 ± 58 (range, 30–418) minutes for septic revision TSA (P = .025). wRVUs per minute were 0.26 for aseptic revision TSA and 0.23 for septic revision TSA (P = .002). Compensation per hour was $504 for aseptic revision TSA and $453 for septic revision TSA (P = .002).</p></div><div><h3>Conclusions</h3><p>Current physician compensation for septic revision TSA does not reflect the greater complexity associated with these procedures compared with aseptic revision TSA. This incongruity may discourage surgeons from performing septic revisions, which could result in delayed or inadequate treatment for patients. Our results suggest a need for a more precise system of wRVU assignment in septic revision TSA cases to ensure that surgeons are compensated fairly.</p></div><div><h3>Level of evidence</h3><p>Level III; retrospective study.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 4","pages":"Article 100471"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001668/pdfft?md5=34dad041d87ede8ce4d96616d6b4245a&pid=1-s2.0-S2773157X24001668-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Comparison of physician compensation using work relative value units in septic revision total shoulder arthroplasty\",\"authors\":\"Arman Kishan , Sarah I. Goldfarb , Kiyanna Thomas , Sanjay Kubsad , Ansh Kishan , Jacob D. Mikula , Henry Maxwell Fox , Umasuthan Srikumaran\",\"doi\":\"10.1016/j.jorep.2024.100471\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Revision total shoulder arthroplasty (TSA) for prosthetic joint infection (herein, “septic revision TSA”) requires more time and resources compared with revision in the absence of infection (“aseptic revision TSA”). Physician compensation should accurately reflect this greater burden. In this study, we assessed whether physician compensation for septic revision TSA is proportionate to that for aseptic revision TSA.</p></div><div><h3>Methods</h3><p>The National Surgical Quality Improvement Program database was queried from 2006 to 2021 to identify cases of aseptic and septic revision TSA. Work relative value units (wRVUs), operative time, wRVUs per minute, and compensation per hour were compared between aseptic and septic cases. Univariate and multivariate analyses were conducted to assess wRVU adequacy for septic revision TSA. The wRVU-to-dollar conversion factor was obtained from the US Centers for Medicare & Medicaid Services, and wRVU dollar valuations were calculated. P values < 0.05 were considered significant.</p></div><div><h3>Results</h3><p>Mean (± standard deviation) operative times were 125 ± 62 (range, 21–695) minutes for aseptic revision TSA and 135 ± 58 (range, 30–418) minutes for septic revision TSA (P = .025). wRVUs per minute were 0.26 for aseptic revision TSA and 0.23 for septic revision TSA (P = .002). Compensation per hour was $504 for aseptic revision TSA and $453 for septic revision TSA (P = .002).</p></div><div><h3>Conclusions</h3><p>Current physician compensation for septic revision TSA does not reflect the greater complexity associated with these procedures compared with aseptic revision TSA. This incongruity may discourage surgeons from performing septic revisions, which could result in delayed or inadequate treatment for patients. Our results suggest a need for a more precise system of wRVU assignment in septic revision TSA cases to ensure that surgeons are compensated fairly.</p></div><div><h3>Level of evidence</h3><p>Level III; retrospective study.</p></div>\",\"PeriodicalId\":100818,\"journal\":{\"name\":\"Journal of Orthopaedic Reports\",\"volume\":\"4 4\",\"pages\":\"Article 100471\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2773157X24001668/pdfft?md5=34dad041d87ede8ce4d96616d6b4245a&pid=1-s2.0-S2773157X24001668-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2773157X24001668\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2773157X24001668","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Comparison of physician compensation using work relative value units in septic revision total shoulder arthroplasty
Background
Revision total shoulder arthroplasty (TSA) for prosthetic joint infection (herein, “septic revision TSA”) requires more time and resources compared with revision in the absence of infection (“aseptic revision TSA”). Physician compensation should accurately reflect this greater burden. In this study, we assessed whether physician compensation for septic revision TSA is proportionate to that for aseptic revision TSA.
Methods
The National Surgical Quality Improvement Program database was queried from 2006 to 2021 to identify cases of aseptic and septic revision TSA. Work relative value units (wRVUs), operative time, wRVUs per minute, and compensation per hour were compared between aseptic and septic cases. Univariate and multivariate analyses were conducted to assess wRVU adequacy for septic revision TSA. The wRVU-to-dollar conversion factor was obtained from the US Centers for Medicare & Medicaid Services, and wRVU dollar valuations were calculated. P values < 0.05 were considered significant.
Results
Mean (± standard deviation) operative times were 125 ± 62 (range, 21–695) minutes for aseptic revision TSA and 135 ± 58 (range, 30–418) minutes for septic revision TSA (P = .025). wRVUs per minute were 0.26 for aseptic revision TSA and 0.23 for septic revision TSA (P = .002). Compensation per hour was $504 for aseptic revision TSA and $453 for septic revision TSA (P = .002).
Conclusions
Current physician compensation for septic revision TSA does not reflect the greater complexity associated with these procedures compared with aseptic revision TSA. This incongruity may discourage surgeons from performing septic revisions, which could result in delayed or inadequate treatment for patients. Our results suggest a need for a more precise system of wRVU assignment in septic revision TSA cases to ensure that surgeons are compensated fairly.
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