No Evidence of the Effect of the Interventions to Combat Health Care Fraud and Abuse A Systematic Review of Literature 英文参考文献.docVIP

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No Evidence of the Effect of the Interventions to Combat Health Care Fraud and Abuse A Systematic Review of Literature 英文参考文献.doc

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No Evidence of the Effect of the Interventions to Combat Health Care Fraud and Abuse A Systematic Review of Literature 英文参考文献

NoEvidenceoftheEffectoftheInterventionstoCombat HealthCareFraudandAbuse:ASystematicReviewof Literature ArashRashidian1,2*,HosseinJoudaki3,TarynVian4 1Department of Health Management and Economics, School of Public Health, Tehran, Iran, 2Knowledge Utilization Research Center, Tehran University of Medical Sciences,Tehran, Iran, 3DepartmentofHealth Management andEconomics,School of Public Health,Tehran University ofMedical Sciences, Tehran, Iran, 4School of PublicHealth,BostonUniversity,Boston,Massachusetts,UnitedStatesofAmerica Abstract Background:Despitetheimportanceofhealthcarefraudandthepolitical,legislativeandadministrativeattentionspaidto it,combatingfraudremainsachallengetothehealthsystems.Weaimedtoidentify,categorizeandassesstheeffectiveness oftheinterventionstocombathealthcarefraudandabuse. Methods: The interventions to combat health care fraud can be categorized as the interventions for ‘prevention’ and ‘detection’offraud,and‘response’tofraud.WeconductedsensitivesearchstrategiesonEmbase,CINAHL,andPsycINFO from 1975 to 2008, and Medline from 1975–2010, and on relevant professional and organizational websites. Articles assessingtheeffectivenessofanyinterventiontocombathealthcarefraudwereeligibleforinclusioninourreview.We considered including the interventional studies with or without a concurrent control group. Two authors assessed the studies for inclusion, and appraised the quality of the included studies. As a limited number of studies were found, we analyzedthedatausingnarrativesynthesis. Findings:Thesearchesretrieved2229titles,ofwhich221full-textstudieswereassessed.WefoundnostudiesusinganRCT design.Onlyfouroriginalarticles(fromtheUSandTaiwan)wereincluded:twostudieswithinthedetectioncategory,onein theresponsecategory,oneunderthedetectionandresponsecategories,andnostudiesunderthepreventioncategory. Thefindingssuggestthatdata-miningmayimprovefrauddetection,andlegalinterventionsaswellasinvestmentinanti- fraudactivitiesmayreducefraud. Discussion:Ouranalysiss