2013년부터 2023년까지 외과계 진료과들의 검사 청구량 분석: 재출판본

Abstract

Background and Objectives The relative value scale (RVS) system in Korea categorizes medical services into five types: surgery, treatment, function tests, laboratory tests, and radio- logic examinations. This study aimed to compare changes that took place over the past decade in diagnostic test utilization and relative value unit distribution in the otolaryngology depart- ment compared to that in other surgical departments. Subjects and Method We analyzed the National Health Insurance claims data for all diag- nostic test items billed in 2013, 2018, and 2023. For each test item, we extracted its RVS point value and claim frequency across nine surgical specialties, stratified by institution type. We calculated the total number of test claims, total RVS-weighted test usage, and the average RVS points per test item by specialty. In addition, we assessed specialist-level intensity by calculat- ing the RVS-based test usage per board-certified physician in each specialty. Results From 2013 to 2023, all surgical departments showed an increase in test claims. Gen- eral surgery, orthopedics, and ophthalmology had the highest total claim volumes. While most tests were performed in neurosurgery, thoracic surgery, and urology in tertiary/general hospi- tals, diagnostic testing in ophthalmology remained concentrated in smaller hospitals and clin- ics. In otolaryngology, a minimal growth in test claims was noted in high-level institutions while a marked increase in test claims came from clinics and hospitals. Also observed was relatively low test usage per physician in the otolaryngology sector. By 2023, the average RVS points per test item remained lowest in orthopedics, plastic surgery, and ophthalmology, while thoracic surgery and otolaryngology maintained higher averages. Conclusion The relatively low per-physician test usage in otolaryngology—despite the high average RVS values—may indicate limitations in test scalability and institutional practice en-vironments.