no evidence of the effect of the interventions to combat health care fraud and abuse a systematic review of literature没有证据表明干预措施的效果应对卫生保健欺诈和滥用系统回顾文献.pdfVIP

No Evidence of the Effect of the Interventions to Combat Health Care Fraud and Abuse: A Systematic Review of Literature 1,2 3 4 Arash Rashidian *, Hossein Joudaki , Taryn Vian 1 Department of Health Management and Economics, School of Public Health, Tehran, Iran, 2 Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran, 3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, 4 School of Public Health, Boston University, Boston, Massachusetts, United States of America Abstract Background: Despite the importance of health care fraud and the political, legislative and administrative attentions paid to it, combating fraud remains a challenge to the health systems. We aimed to identify, categorize and assess the effectiveness of the interventions to combat health care fraud and abuse. Methods: The interventions to combat health care fraud can be categorized as the interventions for ‘prevention’ and ‘detection’ of fraud, and ‘response’ to fraud. We conducted sensitive search strategies on Embase, CINAHL, and PsycINFO from 1975 to 2008, and Medline from 1975–2010, and on relevant professional and organizational websites. Articles assessing the effectiveness of any intervention to combat health care fraud were eligible for inclusion in our review. 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 analyzed the data using narrative synthesis. Findings: The searches retrieved 2229 titles, of which 221 full-text studies were assessed. We fo