On the Use of the Concentration Function in Medical Fraud Assessment

Keywords

Statistical learning
Health Analytics
Code:
06/2017
Title:
On the Use of the Concentration Function in Medical Fraud Assessment
Date:
Friday 27th January 2017
Author(s):
Ekin, T.; Ieva, F.; Ruggeri, F.; Soyer, R.
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Abstract:
We propose a simple, but effective, tool to detect possible anomalies in the services prescribed by a health care provider (HP) compared to his/her colleagues in the same field and environment. Our method is based on the concentration function which is an extension of the Lorenz curve widely used in describing uneven distribution of wealth in a population. The proposed tool provides a graphical illustration of a possible anomalous behavior of the HPs and it can be used as a pre-screening device for further investigations of potential medical fraud.
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The American Statistician