Re-Evaluation of Surgeon's work Relative Value Unit in Urology Procedures

Abstract

Background: The most important component of the Relative Value Unit is the Work Relative Value Unit, which measures the work performed by a surgeon for each service. The evidence shows that the Work Relative Value Unit does not accurately reflect surgeons’ work and has shortcomings. The aim of this study is the re-evaluation of the work relative value unit for urology procedures by a new approach, which is the result of expert opinions in a specialized panel.

Materials and Methods: The study was conducted from January 2018 to September 2021 and consisted of a qualitative and a quantitative part. Five common, expensive, and high-risk urology surgical procedures based on hospital information systems, total cost, and expert opinions were selected and included to study. According to the developed approach, the work relative value was determined for the procedures based on time measurement and expert's opinion.

Results: The findings of study showed that work relative values in four procedures are undervalued. The greatest work relative value is related to post-chemotherapy retroperitoneal lymph node dissection. In addition, according to anesthesiologists’ opinion, physical effort, risk, and complexity of urology procedures in comparison with other surgical specialties obtained a score of 2.7 on a scale of 1 to 5.

Conclusion: The proper evaluation of the urology surgeons’ work not only increases the satisfaction and encourages surgeons to perform complex procedures, but also meets the needs of all critical patients in the health system.