Rose C Dimitroyannis, Thomas F Cyberski, Neil S Kondamuri, Sean P Polster, Paramita Das, Peleg M Horowitz, Christopher R Roxbury
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The IBM MarketScan database was queried to identify patients with a diagnosis of pituitary adenoma in 2016 and to analyze their new and return claims between 2016 and 2019. One-way ANOVA and two-sample t-tests were used to examine claim quantity, time in office, and yearly visit time.</p><p><strong>Results: </strong>In the validation study, estimated visit time via E/M codes and actual visit time were statistically different (<i>P</i> < 0.01), with E/M codes underestimating actual time spent in 79.0% of visits. In the MarketScan analysis, in 2016, 2099 patients received a primary diagnosis of pituitary adenoma. There were 8490 additional-related claims for this cohort from 2016 to 2019. The plurality of new office visits were with endocrinologists (n = 857; 29.3%). Total time spent in office decreased yearly, from a mean of 113 min (2016) to 69 min (2019) (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>E/M codes underestimate the length of outpatient visits; therefore, time toxicity experienced by pituitary patients may be greater than reported. Further studies are needed to develop additional assessment tools for time toxicity and promote increased efficiency of care for patients with pituitary adenomas.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Time Burden of Office Visits in Contemporary Pituitary Care, 2016 to 2019.\",\"authors\":\"Rose C Dimitroyannis, Thomas F Cyberski, Neil S Kondamuri, Sean P Polster, Paramita Das, Peleg M Horowitz, Christopher R Roxbury\",\"doi\":\"10.1177/19458924241242198\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The concept of \\\"time toxicity\\\" has emerged to address the impact of time spent in the healthcare system; however, little work has examined the phenomenon in the field of otolaryngology.</p><p><strong>Objective: </strong>To validate the use of Evaluation and Management (E/M) current procedural terminology codes as a method to assess time burden and to pilot this tool to characterize the time toxicity of office visits associated with a diagnosis of pituitary adenoma between 2016 and 2019.</p><p><strong>Methods: </strong>A retrospective cohort study of outpatient office visits quantified differences between timestamps documenting visit length and their associated E/M code visit length. The IBM MarketScan database was queried to identify patients with a diagnosis of pituitary adenoma in 2016 and to analyze their new and return claims between 2016 and 2019. One-way ANOVA and two-sample t-tests were used to examine claim quantity, time in office, and yearly visit time.</p><p><strong>Results: </strong>In the validation study, estimated visit time via E/M codes and actual visit time were statistically different (<i>P</i> < 0.01), with E/M codes underestimating actual time spent in 79.0% of visits. In the MarketScan analysis, in 2016, 2099 patients received a primary diagnosis of pituitary adenoma. There were 8490 additional-related claims for this cohort from 2016 to 2019. The plurality of new office visits were with endocrinologists (n = 857; 29.3%). Total time spent in office decreased yearly, from a mean of 113 min (2016) to 69 min (2019) (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>E/M codes underestimate the length of outpatient visits; therefore, time toxicity experienced by pituitary patients may be greater than reported. Further studies are needed to develop additional assessment tools for time toxicity and promote increased efficiency of care for patients with pituitary adenomas.</p>\",\"PeriodicalId\":7650,\"journal\":{\"name\":\"American Journal of Rhinology & Allergy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Rhinology & Allergy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/19458924241242198\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Rhinology & Allergy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/19458924241242198","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:时间毒性 "这一概念的出现是为了解决在医疗保健系统中花费的时间所产生的影响;然而,在耳鼻喉科领域却很少有人研究过这一现象:目的:验证使用评估与管理(E/M)当前程序术语代码作为评估时间负担的方法,并试用这一工具来描述 2016 年至 2019 年期间与垂体腺瘤诊断相关的门诊时间毒性:一项门诊就诊的回顾性队列研究量化了记录就诊时长的时间戳与相关E/M代码就诊时长之间的差异。通过查询 IBM MarketScan 数据库,确定了 2016 年诊断为垂体腺瘤的患者,并分析了他们在 2016 年至 2019 年期间的新报销单和返还报销单。采用单因素方差分析和双样本 t 检验来研究索赔数量、诊室时间和年度就诊时间:在验证研究中,通过 E/M 代码估算的就诊时间与实际就诊时间存在统计学差异(P P 结论:E/M 代码低估了就诊时间:E/M 代码低估了门诊就诊时间;因此,垂体瘤患者经历的时间毒性可能大于报告的时间毒性。需要进一步研究开发更多的时间毒性评估工具,提高垂体腺瘤患者的护理效率。
The Time Burden of Office Visits in Contemporary Pituitary Care, 2016 to 2019.
Background: The concept of "time toxicity" has emerged to address the impact of time spent in the healthcare system; however, little work has examined the phenomenon in the field of otolaryngology.
Objective: To validate the use of Evaluation and Management (E/M) current procedural terminology codes as a method to assess time burden and to pilot this tool to characterize the time toxicity of office visits associated with a diagnosis of pituitary adenoma between 2016 and 2019.
Methods: A retrospective cohort study of outpatient office visits quantified differences between timestamps documenting visit length and their associated E/M code visit length. The IBM MarketScan database was queried to identify patients with a diagnosis of pituitary adenoma in 2016 and to analyze their new and return claims between 2016 and 2019. One-way ANOVA and two-sample t-tests were used to examine claim quantity, time in office, and yearly visit time.
Results: In the validation study, estimated visit time via E/M codes and actual visit time were statistically different (P < 0.01), with E/M codes underestimating actual time spent in 79.0% of visits. In the MarketScan analysis, in 2016, 2099 patients received a primary diagnosis of pituitary adenoma. There were 8490 additional-related claims for this cohort from 2016 to 2019. The plurality of new office visits were with endocrinologists (n = 857; 29.3%). Total time spent in office decreased yearly, from a mean of 113 min (2016) to 69 min (2019) (P < 0.001).
Conclusions: E/M codes underestimate the length of outpatient visits; therefore, time toxicity experienced by pituitary patients may be greater than reported. Further studies are needed to develop additional assessment tools for time toxicity and promote increased efficiency of care for patients with pituitary adenomas.
期刊介绍:
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.