title: Small-group judgment methods for determining resource-based relative values.
abstract: National telephone surveys used in the Resource-Based Relative Value Scale Study produce reliable and valid relative values of work, but phone surveys are expensive and time consuming. We evaluated three small-group processes as alternatives. We compared national survey work estimates for 38 surgical services to those generated by panels of 11 and 19 highly qualified general surgeons using 1) single-round mail survey; 2) Delphi multiple-round ratings; and 3) modified Delphi with face-to-face discussion. Single-round mail-survey ratings were closest to the national survey; average differences were 11.0% and 12.6%. Delphi feedback led to increased differences: typical values differed by 14.6% and 15.2%. Face-to-face discussion led to still further divergence (21.0%). Single-round mail survey of a small number of experts provides relative work values that compare more favorably to those of the national survey than those obtained from Delphi multiple-round ratings or modified Delphi with face-to-face discussion.
authors.affiliation: Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115.
authors.forename: L L
authors.initials: LL
authors.lastname: Leape
authors.forename: M A
authors.initials: MA
authors.lastname: Freshour
authors.forename: D
authors.initials: D
authors.lastname: Yntema
authors.forename: W
authors.initials: W
authors.lastname: Hsiao
mesh_terms: D003625:Data Collection; D003697:Delphi Technique; D005069:Evaluation Studies as Topic; D005245:Fee Schedules; D017144:Focus Groups / Q000379:methods / Q000592:standards*; D016345:Medicare Part B; D015895:Relative Value Scales; D015203:Reproducibility of Results; D013514:Surgical Procedures, Operative / Q000145:classification* / Q000191:economics; D014481:United States; D016526:Workload / Q000145:classification