title: Measuring deception: test-retest reliability of physicians' self-reported manipulation of reimbursement rules for patients.
abstract: This study examined the test-retest reliability of physicians' self-reported manipulation of reimbursement rules for patients. The test-retest reliability of self-report of three specific tactics were examined: (1) exaggerating the severity of patients' conditions, (2) changing a patient's official (billing) diagnosis, and (3) reporting signs or symptoms that patients did not have. The reliability of a scaled summary measure of physicians' manipulation of reimbursement rules was also assessed. Overall, the authors found high levels of test-retest agreement across all three items and the summary measure. These findings suggest that self-report can be used to produce reliable data on this controversial issue. Specifically, the three items reported here can be used to produce a reliable summary measure of physicians' manipulation of reimbursement rules to help patients obtain care that physicians perceive as necessary.
authors.affiliation: American Medical Association, USA.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: VanGeest
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Wynia
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Cummins
authors.forename: Ira B
authors.initials: IB
authors.lastname: Wilson
mesh_terms: D008192:Deception; D003933:Diagnosis; D004992:Ethics, Medical; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D007344:Insurance Claim Reporting / Q000592:standards* / Q000706:statistics & numerical data; D007357:Insurance, Physician Services / Q000191:economics; D010344:Patient Advocacy / Q000191:economics*; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D017009:Professional Autonomy; D012051:Reimbursement Mechanisms; D015203:Reproducibility of Results; D012650:Self Disclosure; D014481:United States