Outlier Practice Patterns in Mohs Micrographic Surgery: Defining the Problem and a Proposed Solution.

摘要: Importance Outlier physician practices in health care can represent a significant burden to patients and the system. Objective To study outlier Mohs micrographic surgery (MMS) associated factors. Design, Setting, Participants This retrospective analysis of publicly available Medicare Part B claims data from January 2012 December 2014 includes all physicians who received payments for MMS any practice performing on head neck, genitalia, hands, feet region patients. Main Outcomes Measures Characteristics physicians, defined as those whose mean number stages was 2 standard deviations greater than billing MMS. Logistic regression used characteristics with status. Results Our included 2305 individual The per case practicing 1.74, median 1.69, range 1.09 4.11. Overall, 137 perform were above (2 mean = 2.41 case) at least 1 3 examined years, 49 (35.8%) persistent high outliers years. Persistent status solo (odds ratio, 2.35; 95% CI, 1.25-4.35). Volume cases year, experience, geographic location not Conclusions Relevance Marked variation exists skin cancers, which may an additional financial unnecessary Providing feedback reduce unwarranted this metric quality.