Accession Number : ADA256854


Title :   The Appropriateness of Using a Medical Procedure: Is Information in the Medical Record Valid?


Corporate Author : RAND CORP SANTA MONICA CA


Personal Author(s) : Kosecoff, Jacqueline ; Fink, Arlene ; Brook, Robert H ; Chassin, Mark R


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a256854.pdf


Report Date : Jan 1991


Pagination or Media Count : 9


Abstract : Understanding the clinical appropriateness of a procedure's use may be critical in explaining geographic variations in its use. Little is known, however, about whether data on appropriateness can be obtained from a medical record. A national panel of physicians formulated a list of 300 mutually exclusive, detailed clinical indications for performing coronary angiography. Using this list, we compared the reasons physicians perform coronary angiography as revealed in medical records with those given in interviews with the physicians who actually did the procedure. Thirty-five of 47 eligible billing entities (74%) from two Los Angeles Professional Standards Review Organization areas participated. These physicians practiced in 14 hospitals and accounted for 81% of all angiographies performed on Medicare patients in the two areas. Sixty- six records (approximately two per physician) were reviewed; physician interviews were conducted by two trained data collectors who were blinded to each other's results.


Descriptors :   *FILES(RECORDS) , *MEDICAL RESEARCH , CLINICAL MEDICINE , SURGICAL INSTRUMENTS , PHYSICIANS , HEALTH CARE FACILITIES


Subject Categories : Information Science
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE