Influence of the revision of surgical fee schedule on surgeons' productivity in Japan: A cohort analysis of 7602 surgical procedures in 2013-2016

Yoshinori Nakata; Yuichi Watanabe; Hiroto Narimatsu; Tatsuya Yoshimura; Hiroshi Otake; Tomohiro Sawa

doi:10.1177/0951484817740289

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Influence of the revision of surgical fee schedule on surgeons' productivity in Japan: A cohort analysis of 7602 surgical procedures in 2013-2016

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Influence of the revision of surgical fee schedule on surgeons' productivity in Japan: A cohort analysis of 7602 surgical procedures in 2013-2016

Yoshinori Nakata, Yuichi Watanabe, Hiroto Narimatsu, Tatsuya Yoshimura, Hiroshi Otake and Tomohiro Sawa

Health services management research : an official journal of the Association of University Programs in Health Administration, Vol.31(1), pp.51-56

02/01/2018

DOI: 10.1177/0951484817740289

PMID: 29168670

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Abstract

The goal of this study is to evaluate the pure impact of the revision of surgical fee schedule on surgeons' productivity. We collected data from the surgical procedures performed by the surgeons working in Teikyo University Hospital from 1 April through 30 September in 2013-2016. We employed non-radial and non-oriented Malmquist model. We defined the decision-making unit as a surgeon with the highest academic rank in surgery. Inputs were defined as (1) the number of doctors who assisted surgery and (2) the time of surgical operation. The output was defined as the surgical fee for each surgery. We focused on the revisions in 2014 and 2016. We first calculated each surgeon's natural logarithms of the changes in productivity, technique and efficiency in 2013-2014, in 2014-2015 and in 2015-2016. Then, we subtracted the changes in 2014-2015 from the changes in 2013-2014 and in 2015-2016. We analyzed 62 surgeons who performed 7602 surgical procedures. The productivity changes were not significantly different from 0. Their efficiency change was significantly greater than 0, while their technical change was smaller than 0 in revision 2014. Their efficiency change was significantly smaller than 0, while their technical change was greater than 0 in revision 2016 (p < 0.05). This finding suggests that we could increase overall productivity through revision if we could increase both efficiency and technique.

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Details

Title: Subtitle: Influence of the revision of surgical fee schedule on surgeons' productivity in Japan: A cohort analysis of 7602 surgical procedures in 2013-2016
Creators: Yoshinori Nakata - Teikyo University
Yuichi Watanabe - Waseda University
Hiroto Narimatsu - Kanagawa Prefectural Hospital Organization
Tatsuya Yoshimura - Midorigaoka Hospital
Hiroshi Otake - Showa University
Tomohiro Sawa - Teikyo University
Resource Type: Journal article
Publication Details: Health services management research : an official journal of the Association of University Programs in Health Administration, Vol.31(1), pp.51-56
DOI: 10.1177/0951484817740289
PMID: 29168670
NLM abbreviation: Health Serv Manage Res
ISSN: 0951-4848
eISSN: 1758-1044
Publisher: Sage
Number of pages: 6
Grant note: Pfizer Health Research Foundation 17K09247 / Japan Society for the Promotion of Science (JSPS) KAKENHI Grant; Ministry of Education, Culture, Sports, Science and Technology, Japan (MEXT); Japan Society for the Promotion of Science; Grants-in-Aid for Scientific Research (KAKENHI)
Language: English
Date published: 02/01/2018
Academic Unit: Anesthesia
Record Identifier: 9984656532302771

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