The Relative Value Unit in Academic Geriatrics: Incentive or Impediment?
Identifieur interne : 004611 ( Main/Exploration ); précédent : 004610; suivant : 004612The Relative Value Unit in Academic Geriatrics: Incentive or Impediment?
Auteurs : Neil M. Resnick [États-Unis] ; Nichole Radulovich [États-Unis]Source :
- Journal of the American Geriatrics Society [ 0002-8614 ] ; 2014-03.
Descripteurs français
- KwdFr :
- MESH :
- enseignement et éducation : Gériatrie.
- normes : Amélioration de la qualité, Services de santé pour personnes âgées.
- Humains, Sociétés médicales, Sujet âgé, Types de pratiques des médecins.
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
- MESH :
- education : Geriatrics.
- standards : Health Services for the Aged, Quality Improvement.
- Aged, Humans, Practice Patterns, Physicians', Societies, Medical.
Abstract
Although the number of older adults is rapidly expanding, the number of healthcare professionals trained in geriatrics is small and declining. The reasons are multifaceted, but because responsibility for training such professionals resides largely in academic health centers (AHCs), their support for geriatrics is critical. As AHCs face increasing financial pressure, many are seeking metrics to measure productivity and the Relative Value Unit (RVU) may be the one most commonly selected. Yet little is known about the RVU's effect on geriatric programs. Review of the literature and a survey of the leaders of the Association of Directors of Geriatric Academic Programs suggest that the advantages of an RVU‐based metric are likely eclipsed by its negative impact on the care of older adults, the ability of academic geriatrics to accomplish its mission, and even the survival of geriatrics. If the RVU is to continue to be used as the index of productivity, it should be modified—by reweighting its codes (or by adding new ones)—and complemented by interventions to ensure patient access, care quality, and efficiency. Because an alternative metric, such as a Patient‐based Value Unit may be preferable, this article describes the principles on which one might be based. Regardless, urgent action is required by all stakeholders to address this issue. Without it, the future of academic geriatrics—and with it the innovative care models, research, and training the nation needs to improve care and bend the cost curve—will be difficult if not impossible to sustain.
Url:
- https://api.istex.fr/document/E009D3D678687BB0B869D931653ED24205926EC3/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864359
DOI: 10.1111/jgs.12698
Affiliations:
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Le document en format XML
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The reasons are multifaceted, but because responsibility for training such professionals resides largely in academic health centers (AHCs), their support for geriatrics is critical. As AHCs face increasing financial pressure, many are seeking metrics to measure productivity and the Relative Value Unit (RVU) may be the one most commonly selected. Yet little is known about the RVU's effect on geriatric programs. Review of the literature and a survey of the leaders of the Association of Directors of Geriatric Academic Programs suggest that the advantages of an RVU‐based metric are likely eclipsed by its negative impact on the care of older adults, the ability of academic geriatrics to accomplish its mission, and even the survival of geriatrics. If the RVU is to continue to be used as the index of productivity, it should be modified—by reweighting its codes (or by adding new ones)—and complemented by interventions to ensure patient access, care quality, and efficiency. Because an alternative metric, such as a Patient‐based Value Unit may be preferable, this article describes the principles on which one might be based. Regardless, urgent action is required by all stakeholders to address this issue. Without it, the future of academic geriatrics—and with it the innovative care models, research, and training the nation needs to improve care and bend the cost curve—will be difficult if not impossible to sustain.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region><settlement><li>Pittsburgh</li></settlement></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Resnick, Neil M" sort="Resnick, Neil M" uniqKey="Resnick N" first="Neil M." last="Resnick">Neil M. Resnick</name></region><name sortKey="Radulovich, Nichole" sort="Radulovich, Nichole" uniqKey="Radulovich N" first="Nichole" last="Radulovich">Nichole Radulovich</name><name sortKey="Radulovich, Nichole" sort="Radulovich, Nichole" uniqKey="Radulovich N" first="Nichole" last="Radulovich">Nichole Radulovich</name><name sortKey="Radulovich, Nichole" sort="Radulovich, Nichole" uniqKey="Radulovich N" first="Nichole" last="Radulovich">Nichole Radulovich</name><name sortKey="Resnick, Neil M" sort="Resnick, Neil M" uniqKey="Resnick N" first="Neil M." last="Resnick">Neil M. Resnick</name><name sortKey="Resnick, Neil M" sort="Resnick, Neil M" uniqKey="Resnick N" first="Neil M." last="Resnick">Neil M. Resnick</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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