Yoshinori Nakata1, Yuichi Watanabe2, Hiroshi Otake3, Toshihito Nakamura4, Giichiro Oiso5, Tomohiro Sawa6. 1. Teikyo University Graduate School of Public Health, Tokyo, Japan. Electronic address: ynakata@med.teikyo-u.ac.jp. 2. Teikyo University Graduate School of Public Health, Tokyo, Japan. 3. Department of Anesthesia, Showa University School of Medicine, Tokyo, Japan. 4. Department of Health Policy for Aged Society, Chiba University Hospital, Chiba, Japan. 5. Hamamatsu University School of Medicine, Hamamatsu, Japan. 6. Teikyo University Medical Information and System Research Center, Tokyo, Japan.
Abstract
OBJECTIVE: The goal of this study was to calculate total factor productivity of surgeons in an academic year and to evaluate the effect of surgical trainees on their productivity. STUDY DESIGN: We analyzed all the surgical procedures performed from April 1 through September 30, 2013 in the Teikyo University Hospital. The nonradial and nonoriented Malmquist model under the variable returns-to-scale assumptions was employed. A decision-making unit is defined as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of physicians who assisted in surgery, and the time of surgical operation from skin incision to skin closure. The output was defined as the surgical fee for each surgery. April is the beginning month of a new academic year in Japan, and we divided the study period into April to June and July to September 2013. We computed each surgeon's Malmquist index, efficiency change, and technical change. RESULTS: We analyzed 2789 surgical procedures that were performed by 105 surgeons. The Malmquist index of all surgeons was significantly greater than 1 (p = 0.0033). The technical change was significantly greater than 1 (p < 0.0001). However, the efficiency change was not statistically significantly different from 1 (p = 0.1817). CONCLUSIONS: The surgeons are less productive in the beginning months of a new academic year. The main factor of this productivity loss is considered to be surgical training.
OBJECTIVE: The goal of this study was to calculate total factor productivity of surgeons in an academic year and to evaluate the effect of surgical trainees on their productivity. STUDY DESIGN: We analyzed all the surgical procedures performed from April 1 through September 30, 2013 in the Teikyo University Hospital. The nonradial and nonoriented Malmquist model under the variable returns-to-scale assumptions was employed. A decision-making unit is defined as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of physicians who assisted in surgery, and the time of surgical operation from skin incision to skin closure. The output was defined as the surgical fee for each surgery. April is the beginning month of a new academic year in Japan, and we divided the study period into April to June and July to September 2013. We computed each surgeon's Malmquist index, efficiency change, and technical change. RESULTS: We analyzed 2789 surgical procedures that were performed by 105 surgeons. The Malmquist index of all surgeons was significantly greater than 1 (p = 0.0033). The technical change was significantly greater than 1 (p < 0.0001). However, the efficiency change was not statistically significantly different from 1 (p = 0.1817). CONCLUSIONS: The surgeons are less productive in the beginning months of a new academic year. The main factor of this productivity loss is considered to be surgical training.