Establishing the relative value scale (RVS) of physician fees in Taiwan - A review of 79 dental procedures

Objective: The purpose of this study was to establish the relative value scale (RVS) of dental procedures, which may serve as the basis for a dentistry payment system. Methods: Upon the recommendation of the National Dental Association of the Republic of China, a Technical Consultating Group (TCG) was organized to select the Services/Procedures (S/Ps) to be investigated by survey and to establish the basic reference S/Ps for each of the four sub-specialties. After stratified random sampling, the Delphi Technique was used for two rounds of survey. In the questionnaire, we asked the respondents to magnitude estimate the weight of the S/Ps against the base S/P of each sub-specialty respectively. After adjusting the survey results to the sample size, we then asked the TCG to evaluate the results and to estimate the workload of the un-surveyed S/Ps. Finally, we readjusted them to a, common scale for all S/Ps of the four sub-specialties. Results: (1) Both the validity and reliability of the survey were acceptable. We have set up a local RVS for 79 dental procedures. (2) Although other factors such as practice costs were not included, the results of the present study correlated well with the dental payment system of the NHI. Of the four sub-specialties, the RVS of Oral Surgery (OS) correlated best with the payment system of the NHI, while the lowest was the RVS of Endodontics (Endo). (3) Time is the least important of the four dimensions of a dentists' workload. (4) The workload of a dentist is not affected by the location of his practice place, urban or rural, hospital or clinic. Conclusion: (1) It is appropriate to use the RBRVS method to establish a RVS for the workload of dentists in Taiwan. (2) We have set up a local RVS for 79 dental procedures. (3) The NHI dental fee scale for some S/Ps needs to be re-evaluated.