Analyzing Medical Invoices Data
Because of privacy issues it is not easy to acquire and use actual medical datafiles in The Netherlands. In the past I worked with invoices from Health Insurance Companies. Always there were ways for declarants to bypass and ‘defeat’ the system. This is a ‘historical’ Excel Datafile of 2002-2005 for some Hospitals. By using Fusiontables I can select the 480 files of code C105190305 (= Total Hip) and 291 files of C106190306 (= knee prosthesis).
Example (Fusiontables) ‘Total Hip’
The price of the total hip (activity C105190305) = 2000 Euro. In the middle the column with the time stamp. In the right column the code of the declarant.
With these type of files it was possible to benchmark and find anomalies. This is history……
Oorsmeer (ear wax =cerumen) Gate (Source: Volkskrant Jan. 13th 2013)
Recently there was much to do about upcoding (=high declarations) by E.N.T. specialists.
Why these Ear Wax Problems?
Nowadays there is another Invoice system. The DBC (Diagnose Behandel Combinatie = Diagnosis Treatment Combination). There is one price for a certain DBC. Registration is very important now, because treatments can be different within the same DBC . Some simple treatments (like the removal of debris = cerumen from the ear ) however are free of charge. So often an existing other activity (like code 12) is administered by E.N.T. specialists …. In this DBC (code 12) belongs policlinical treatments like removal of a corpus alienum or a polyp from the external ear. In the graph one can see that the percentage of this treatment group (code 12) is rising from 18% to 24 % within 4 years (Source NZA). Probably this is partly upcoding practice ( when actually only ear wax is removed).
Excel (Data Source NZA)
Of course this graph (code 12) only reflects a percentage of a group of DBC’s which all are also rising in this period from 2008-2011. However, it is said by Health Authorities that code 12 is rising relatively fast. So E.N.T. specialists are ‘in the picture’ now. Your comment please! (My final work in the MOOC course Infographics)