دورية أكاديمية
Characterizing physician directory data quality: variation by specialty, state, and insurer.
| العنوان: | Characterizing physician directory data quality: variation by specialty, state, and insurer. |
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| المؤلفون: | Butala NM; Rocky Mountain Regional VA Medical Center, 1700 N Wheeling St, Aurora, CO, 80045, USA. Neel.butala@cuanschutz.edu.; University of Colorado School of Medicine, Aurora, CO, USA. Neel.butala@cuanschutz.edu., Jiwani K; Hilabs, Inc, Bethesda, MD, USA., Bucholz EM; University of Colorado School of Medicine, Aurora, CO, USA.; Children's Hospital Colorado, Aurora, CO, USA. |
| المصدر: | BMC health services research [BMC Health Serv Res] 2024 Jul 18; Vol. 24 (1), pp. 808. Date of Electronic Publication: 2024 Jul 18. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
| مواضيع طبية MeSH: | Physicians*/statistics & numerical data , Data Accuracy*, United States ; Humans ; Insurance Carriers/statistics & numerical data ; Directories as Topic ; Medicine/statistics & numerical data ; Insurance, Health/statistics & numerical data ; Specialization/statistics & numerical data |
| مستخلص: | Background: As U.S. legislators are urged to combat ghost networks in behavioral health and address the provider data quality issue, it becomes important to better characterize the variation in data quality of provider directories to understand root causes and devise solutions. Therefore, this manuscript examines consistency of address, phone number, and specialty information for physician entries from 5 national health plan provider directories by insurer, physician specialty, and state. Methods: We included all physicians in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) found in ≥ 2 health insurer physician directories across 5 large national U.S. health insurers. We examined variation in consistency of address, phone number, and specialty information among physicians by insurer, physician specialty, and state. Results: Of 634,914 unique physicians in the PECOS database, 449,282 were found in ≥ 2 directories and included in our sample. Across insurers, consistency of address information varied from 16.5 to 27.9%, consistency of phone number information varied from 16.0 to 27.4%, and consistency of specialty information varied from 64.2 to 68.0%. General practice, family medicine, plastic surgery, and dermatology physicians had the highest consistency of addresses (37-42%) and phone numbers (37-43%), whereas anesthesiology, nuclear medicine, radiology, and emergency medicine had the lowest consistency of addresses (11-21%) and phone numbers (9-14%) across health insurer directories. There was marked variation in consistency of address, phone number, and specialty information by state. Conclusions: In evaluating a large national sample of U.S. physicians, we found minimal variation in provider directory consistency by insurer, suggesting that this is a systemic problem that insurers have not solved, and considerable variation by physician specialty with higher quality data among more patient-facing specialties, suggesting that physicians may respond to incentives to improve data quality. These data highlight the importance of novel policy solutions that leverage technology targeting data quality to centralize provider directories so as not to not reinforce existing data quality issues or policy solutions to create national and state-level standards that target both insurers and physician groups to maximize quality of provider information. (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.) |
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| فهرسة مساهمة: | Keywords: Health informatics; Health insurance; Health plan; Information technology infrastructure; Physician directory |
| تواريخ الأحداث: | Date Created: 20240717 Date Completed: 20240717 Latest Revision: 20240720 |
| رمز التحديث: | 20240720 |
| مُعرف محوري في PubMed: | PMC11256460 |
| DOI: | 10.1186/s12913-024-11269-5 |
| PMID: | 39020337 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1472-6963 |
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| DOI: | 10.1186/s12913-024-11269-5 |