The Appropriateness of Using a Medical Procedure: Is Information in the Medical Record Valid?
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.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 1991
- Accession Number
- ADA256854
Entities
People
- Arlene Fink
- Jacqueline Kosecoff
- Mark R. Chassin
- Robert H. Brook
Organizations
- RAND Corporation