Are Gender-Affirming Plastic Surgeons Adequately Compensated? An Analysis of Relative Value Units.
Are Gender-Affirming Plastic Surgeons Adequately Compensated? An Analysis of Relative Value Units.
复制标题
肯定性别的整形外科医生是否得到了足够的补偿？
DOI：
10.1097/sap.0000000000003708
复制
发表时间：
2024
影响因子：
1.5
通讯作者：
Taub,PeterJ
中科院分区：
文献类型：
--
作者：
Oleru,OlachiO;Seyidova,Nargiz;Taub,PeterJ
背景性别肯定手术（GAS）在美国医疗保健领域有着复杂的历史。随着 GAS 手术和报销的持续上升趋势，本研究旨在调查 GAS 手术和一般整形外科手术之间的补偿是否公平。方法查询国家手术质量改进计划数据库，查询 2016 年至 2020 年整形外科医生进行的所有手术。使用 ICD-10 代码将病例分配到 GAS 或非 GAS 队列。删除了重复的当前程序术语 (CPT) 代码以进行分析。比较各队列之间的手术时间、总 wRVU、每小时 wRVU (wRVU/h)、再手术/再入院率以及并发手术数量。结果共鉴定出 132,319 例非 GAS 和 3,583 例 GAS。删除重复的 CPT 后，GAS 队列中保留了 299 例（21 个独特的 CPT），非 GAS 队列中保留了 20,022 例（37 个独特的 CPT）。 GAS 队列的手术时间较长（262.9 分钟 vs 120.7 分钟，P < 0.001），总 wRVU 也较长（59.4 分钟 vs 21.6 分钟，P < 0.001）。再手术/再入院率（7.0% vs 6.0%）和wRVU/h（15.8 vs 15.1）无显着差异（均P>0.05）。总手术时间与总 wRVU 之间呈正相关（P < 0.001），总手术时间与 wRVU/h 之间呈负相关（P < 0.001）。 结论 按比例将 wRVU 分配给性别确认整形手术。然而，对于 GAS 和一般整形手术，RVU 量表并未将成比例的 wRVU 分配给较长的手术时间。性别肯定整形手术的报酬高于一般整形手术；但是，相比之下，每小时的 wRVU 数没有差异。
BackgroundGender-affirming surgery (GAS) has a complicated history within US health care. As GAS procedures and reimbursement availability continue to uptrend, the present study aims to investigate whether compensation is equitable between GAS procedures and general plastic surgery procedures.MethodsThe National Surgical Quality Improvement Program database was queried for all surgeries performed by plastic surgeons from 2016 to 2020. Cases were assigned to the GAS or non-GAS cohort using ICD-10 codes. Duplicate Current Procedural Terminology (CPT) codes were removed for analysis. Operative time, total wRVUs, wRVUs per hour (wRVU/h), reoperation/readmission rate, and number of concurrent procedures were compared between the cohorts.ResultsA total of 132,319 non-GAS and 3,583 GAS were identified. After duplicate CPT removal, 299 cases (21 unique CPTs) remained in the GAS cohort and 20,022 (37 unique CPTs) in the non-GAS cohort. Operative time was higher in the GAS cohort (262.9 vs 120.7 min, P< 0.001), as were total wRVUs (59.4 vs 21.6, P< 0.001). Reoperation/readmission rate (7.0% vs 6.0%) and wRVU/h (15.8 vs 15.1) were not significantly different (all P> 0.05). There was a positive correlation between total operative time and total wRVUs (P< 0.001) and a negative correlation between total operative time and wRVU/h (P< 0.001).ConclusionsProportional wRVUs are allocated to gender affirming plastic procedures. However, the RVU scale does not allocate proportional wRVUs to longer operative times for both GAS and general plastic surgeries. Compensation for gender affirming plastic surgeries is higher than that of general plastic surgeries; however, there is no difference in wRVUs per hour on comparison.