Rasch analysis in measurement of physician work

Abstract

This report describes the use of Rasch analysis of paired comparisons in measuring physician work. The method examines the ranking of a series of related medical or surgical procedures by survey of physicians experienced in the provision of such services. Each service in the group is paired with every other service. The physicians select which of a pair of services from the group under study represents the greater amount of physician work. When the results are analyzed by Rasch method, the resulting measures (in logits) provide a scale (yardstick) upon which each service can be placed relative to all the other services in the group. In this way, a rank ordering of the services is accomplished that is both linear and objective. The Rasch measures can than be charted against existing work values to refine the assigned relative values for such services. The result of applying this method to a series of spinal operations indicates that this technique could be expanded to many other groups of related medical services, with improved relative valuation of physician work.