...
Department of Health and Human Servces 
OFFICE OF 
INSPECTOR GENERAL 
NATIONAL PRACTITIONER DATA BANK: 
PROFILE OF MATCHES 
S'ERVIC1" 
Richard P. Kusserow 
INSPECfOR GENERA 
'0 
o,d'3a  APRI 199  OFFICE OF INSPECTOR GENERA 
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-
452, as
amended, is to protect the integrity of the Department of Health and Human Servces
' (HHS)
programs as well as the health and welfare of beneficiaries served by those programs. This 
statutory mission is carried out through a nationwide network of audits
, investigations, and
inspections conducted by three OIG operating components: the 
Offce of Audit Services, the
Offce of Investigations, and the Offce of Evaluation and Inspections. The OIG also 
informs
the Secretary of HHS of program , and management problems, and recommends courses to
correct them. 
OFFICE OF AUDIT SERVICE 
The OIG's Offce of Audit Servces (OAS) provides all auditing services for HHS, either by
conducting audits with its own audit resources or by overseeing audit work done by others. 
Audits examine the performance of HHS programs and/or its grantees and contractors in 
carryng out their respective responsibilties and are intended to provide independent 
assessments of HHS programs and operations in order to reduce waste
, abuse, and
mismanagement and to promote economy and effciency throughout the Department. 
OFFICE OF INTIGATIONS 
The OIG'
s Offce of Investigations (01) conducts criminal, civil, and administrative
investigations of allegations of wrongdoing in HHS programs or to HHS beneficiaries and of 
unjust enri hment by providers. The investigative efforts of 01 lead to criminal convictions 
administrative sanctions, or civil money penalties. The .01 also oversees State Medicaid fraud 
control units which investigate and prosecute fraud and patient abuse in the Medicaid program. 
OFFICE OF EVALUATION AN INSPECTONS 
The OIG's Offce of Evaluation and Inspections (OEI) conducts short-term management and
program evaluations (called inspections) that focus on issues of concern to the Department 
the Congress , and the public. The findings and recommendations contained in these inspection 
reports generate rapid , accurate, and up-to-date information on the effciency, vulnerability,
and effectiveness of departmental programs. 
This report was prepared in the Boston Regional offce under the direction of Regional 
Inspector General Mark R. Yessian, Ph.  , and Deputy Regional Inspector General Martha B.
Kvaal. Project staff include: 
David Veroff Project Leader 
Lead Analyst 
David Schrag, 
Alan Levine Headquarters  ...~
Department of Health and Human Servces 
OFFICE OF 
INSPECTOR GENERAL 
NATIONAL PRACTITIONER DATA BANK: 
PROFILE OF MATCHES 
..SEIWIC't.. 
Richard P. Kusserow 
INSPECTOR GENERAL 
'0 
'lb'''dia 
OEI-Ol-90-O522  EXECUTIVE 
SUMMAR Y

PUROSE 
Ths report profiles the set of occasions--known as matches--on which the National 
Practitioner Data Bank has provided records of malpractice payments or adverse 
actions to queryng entities. 
BACKGROUN 
The National Practitioner Data Bank opened on September 1
, 1990. It maintains
records of malpractice payments (both judgments and settlements) and adverse actions 
against licensed health care practitioners. The Data Bank provides hospitals and other 
health care entities with information relating to the professional competence and 
conduct of physicians, dentists, and other health care practitioners. The Data Bank 
receives reports of adverse actions against practitioners from State licensing boards 
hospitals and other health care entities, and professional societies. It receives reports 
of malpractice payments from malpractice insurers. 
The Data Bank has received approximately 1 000 000 requests for information 
(referred to as "queries ) and 25 000 reports of adverse actions or malpractice 
payments. When a query names a practitioner who has been reported to the Data 
Bank, the query-record pair is referred to as a "match. 
The Office of Inspector General analyzed all Data Bank matches through March 19 
1992, in preparation for a study on the use and utility of the information stored in the 
Data Bank. This analysis yielded rich information about the Data Bank' s history that
was unavailable elsewhere. To make available this information, which we believe may
affect the management of the Data Bank, we are providing in this report a profile of
all matches. The report answers some basic questions about the Data Bank' 
operations. The statistics presented do not reflect the use or utility of the information 
obtained by queriers through matches. Our forthcoming report
, however, will put
these statistics in context. We will survey a sample of queriers who have had matches
and determine what tyes of matches are most 
valuable. 
FIINGS 
954 matche ha occued Almt all 
As of March  19, 1992,  of the involved 
hoitals receig informtin about physin'. 
In 93 percent the practitioner involved was a physician.

In 91 percent the querier involved was a hospital.  pa; 
innt 
In  88  peen of matche, the  involved was a malpractie  th other 
12 percent involved adverse actino. 
Half of the malpractice matches involved payments of $50 
000 or less; most
involved recent incidents. 
Licensing boards and hospitals each accounted for about half of the adverse 
action records involved in matches. 
li 
Nrn peen of  cred 
matche involved prctine who  Slale  seekig work 
APPENICE 
In four appendices, we provide details on the tyes of practitioners, queriers
malpractice payments, and adverse actions involved in matches.  .......................................... 
. ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  ..  .. ..  ..  ..  ..  ..  ..  ..  ..  ..  . . 
TABLE OF 
CONTENTS
PAGE
EXECUTIVE SUMMAY
INRODUCTION. . . . . . . 
. . . . . . 1

FINDINGS. . . . . . . . . . . 
. . . . . . . . 3 
How many matches have occurred to date? 
........................... 3 
What kinds of practitioners have been involved in matches? 
............... 3 
What kinds of queriers have had matches? . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . 3 
What kinds of reports have resulted in matches? 
....................... 4 
Has the Data Bank supplied information on practitioners 
who crossed State lines? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . 5
APPENDICES
A. Practitioners Involved in Matches. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . A 
B. Queriers Involved in Matches. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . .. B 
C. Malpractice Payment Records Involved in Matches. . . . . . . . . . . . . . . . . . . .. C 
D. Adverse Action Records Involved in Matches. . . . . . . . . . . . . . . . . . 
. . . . . . . D 
E. Notes 
............... ...................................... E-
 INTRODUCTION 
PUROSE 
This report profies the set of occasions--known as matches--on which the National 
Practitioner Data Bank has provided records of malpractice payments or adverse 
actions to queryng entities. 
BACKGROUN 
The National Practitioner Data Bank maintains records of malpractice judgments and 
adverse actions against licensed health care practitioners. It was established by Title 
IV of the Health Care Qllality Improvement Act of 
1986 (P. 660), and has been
L. 99-
in operation since September 1, 1990. The Data Bank is funded by user fees and 
Federal outlays and is administered by Unisys Corporation under contract to the 
Health Resources and Servces Administration (HRSA) of the Public Health Servce 
(PHS). 
The Data Bank provides hospitals and other health care entities with information 
relating to the professional competence and conduct of physicians, dentists, and other 
health care practitioners. Congress believed it could, among other things, help
restrict the ability of incompetent physicians to move from State to State without 
disclosure or discovery of the physician s previous damaging or incompetent 
performance. 
DEFION 
OF TERMS USED IN THS REPORT 
REPORT	 Information sent to the Data Bank about a 
practitioner by a malpractice insurer
, hospital 
licensing board, or professional society. 
RECORD  A report that has been received and is 
permanently stored by the Data Bank. 
QUERY  A request for information about a practitioner 
submitted to the Data Bank by a hospital 
licensing board, or other health care entity. 
MATCH  A pairing of a record and query that identifies 
the same practitioner.  Reports of adverse actions against practitioners are submitted to the Data Bank by 
State licensing boards, hospitals and other health care entities, and professional 
societies? These groups must report actions against physicians and dentists, and 
health care entities and professional societies may report actions against other licensed 
practitioners. Reports of malpractice payments are submitted by insurers, who must 
report all judgments and settlements made on behalf of all licensed practitioners. 
Data Bank records may be released only to authorized entities. These entities 
(referred to as "queriers ) include hospitals and other health care entities 4 State 
licensing boards, professional societies, and, under specified conditions, plaintiffs
attorneys in malpractice suits. Also, practitioners may request their own records. 
Only hospitals are required by law to query the Data Bank. They must request 
records for practitioners wishing to obtain clinical privileges and
, every two years, for 
all practitioners with privileges.

When a hospital, licensing board, or other health care entity requests information on a
certain practitioner from the Data Bank, and that practitioner has been reported to 
the Data Bank, the query-record pair is referred to as a "match. " Through November 
, 1991 (the most recent date for which complete statistics are available), the Data 
Bank had received 959 753 queries and 23 396 adverse action or malpractice payment 
6 These queries and reports had resulted in approximately 9 
reports.
000 matches. 
The Offce of Inspector General analyzed Data Bank matches in preparation for a 
study of the use and utilty of the information stored in the Data Bank. This 
analysis 
yielded rich information about the Data Bank's history that was unavailable elsewhere. 
To make available this information, which we believe may affect the management of 
the Data Bank, we are providing in this report a profie of all matches through March 
, 1992. The report answers some basic questions about the Data Bank' 
s operations. 
The statistics presented in this report do not reflect the use or utility of the 
information obtained by queriers through matches. Our forthcoming report
, however
will put these statistics in context. We will 
survey a sample of queriers who have had
matches and determine what tyes of matches are most 
valuable. 
METHODOLOY 
The Offce of Inspector General (OIG) requested and received from 
Unisys 
Corporation a computer fie containing records as of March 19, 1992, of all queries
and reports received by the Data Bank that identified the same practitioner.8 We 
restructured and analyzed the data using Version 6.04 of the SAS System for Personal
9 We also obtained statistics pertaining to all reports and queries received 
Computers.
by the Data Bank, whether or not they were involved in matches, as of November 22
1991. This information was not available through March 
1992. Our review was 
conducted in accordance with the 
 Interim Standards for Inopections 
 issued by the
President' s Council on Integrity and Efficiency.  FINDINGS
OCD 
MA 
HOW  MATCH HAVE  TO DATE? 
19, 1992
954 as of March 
Between September 1, 1990, and March 19, 1992, a total of 20 954 records of adverse
actions or malpractice payments were sent to Data Bank queriers. 
In addition, there
were a number of "  choes
" (in which a querier receives information it had previously 
lO None of these (1 
submitted), duplicate records, and duplicate queries. 939 matches 
in all) constituted a real transfer of information, and thus they are not included in any 
of our statistics.u
The 20 954 matches resulted from 19 034 queries. This means that each query 
involved in a match provided the querier with an average of 
1.0 (20 954 + 19 034)
records per practitioner. 
The number of matches increased sharply between November 1991
, when there were 
about 9 000 matches Much of that increase is due to 
, and March  1992.1 
improvements made by the Data Bank administrators in resolving partial matchesY 
The Data Bank project officer estimated that 8 000 partial matches were resolved in
February and March 1992 and that most of these resulted in matches.14 Prior to
February 1992, the Data Bank had no mechanism for resolving these matches. 
WHT KIS OF PRACll'10NERS HAVE BEEN INOLVED IN MATCH? 
Nearl all are physicino.
There were 10 185 different practitioners represented in matches,1 Ninety-three 
percent of the matches involved physicians (18 257 involved allopathic physicians and
161 inv01ved osteopathic physicians); 4 percent involved dentists. Appendix A
displays the tyes of practitioners involved in matches.
Physicians are apparently overrepresented in matches. Just 75 percent of the  reports
submitted to the Data Bank involved physicians, compared with 91 percent of the 
matches.16  This disparity is likely explained by the fact that hospitals are the only 
mandated queriers of the Data Bank and are most likely to query about 
physicians. 
WHT KIS OF QUERS HAVE HA MATCH?

Nearl all are hopitals.
A total of 4 357 queriers submitted queries that led to matches. A vast majority of the 
matches resulted from queries submitted by hospitals (91.2 percent). Health 
maintenance organizations and preferred provider organizations accounted for  3 percent and other health care entities for 1.8 percent. The remaining 0.
6 percent
were distributed among State licensing boards
, group practices, and professional 
societies. (Appendix B displays these figures in tabular form.
) These proportions are 
not unexpected. Hospitals are the only organizations required to query the Data 
Bank. Other organizations that may be interested in queryng in the future have 
various reasons for not doing so at this timeP 
Most of the 19 122 hospital matches resulted from mandatory two-
year queries 
(64.3 percent). Initial privileging and employment queries accounted for 33.9 percent
and professional review activity accounted for 1.6 percent. 
Most queriers had matches on a small number of practitioners; the mean was 4. 
practitioners matched per querier. Thirt-
two percent of queriers matched on exactly 
1 practitioner, and 76 percent matched on 5 or fewer. A few queriers matched on 
many more practitioners; 1 health pJan had matches on 134 different practitioners.
WHT KIS OF REPORTS HAVE REULTED IN MATCH? 
pay; 
Nearl all are malpractie  just  12  peent are adverse actin' of lien'g
board, health care ent
profesnal socti. 
, or 
A total of 938 reporters have submitted 11 296 adverse action or malpractice reports 
that have been matched.  Malpractice payment records made up 88 percent of all 
the matches; adverse actions made up 12 percent. The corresponding 
percentages for
all reports to the Data Bank were 85 and 15. 
Half of the malpractice matches involved payments of $50 000 or less; most 
involved recent incidents. 
Malpractice payment amounts ranged from $1 to $4 
675 000, with a mean of 
$132 358.  Most matches involved payments well below the mean; the median 
payment amount was only $50 000. 
in 1961.23 
Most matches involved fairly recent incidents of malpractice. Fifty-
three percent 
involved incidents occurring in 1987 or later (including 11 that were erroneously 
reported as occurring after 1992). The earliest incident involved in a match occurred
A majority of the malpractice records that appeared in matches fell into three major 
categories of acts or omissions: 32 percent were surgery-related
, 28 percent diagnosis-
related, and 19 percent treatment-related. Appendix C 
summarizes the tyes of acts 
or omissions.  Licen'ing boards and hospitals each accounted for about half of the adverse 
action records involved in matches. 
Adverse action records appearing in matches came from two major sources. Fifty-
two percent came from licensure actions submitted by State boards and 47 percent 
from hospital clinical privileges actions. The remaining 1 percent came from 
professional societies reporting about membership actions. 
Overall, 71 percent of adverse action reports received by the Data Bank were 
licensure actions and 28 percent were clinical privileges actions.24 One hypothesis to 
reportng
account for the difference between the  match  proportions and the 
proportions is that practitioners who have serious licensure actions taken against them 
may refrain from seeking credentials. If they do refrain, their records will not be 
requested and they will not be involved in matches. 
The specific actions taken against practitioners that show up in matches include 
probation of license (23 percent of adverse action matches) and denial of clinical 
privileges (12 percent). The reasons for action include incompetence
, malpractice
and negligence (16 percent of adverse action matches), unprofessional conduct 
(11 percent), and alcohol and other substance abuse (10 percent).25 Appendix D 
summarizes the tyes of actions and 
reasons for actions. 
HA TH DATA BAN SUPPLID INORMTION  cun
ON PRA ONERS 
LIN? 
WHO CROSED STATE 
It ha happene  956  ti; ie., in  9.3  percen of all matche. 
One of Congress s priorities in establishing the Data Bank was to prevent incompetent 
and unprofessional practitioners from evading detection by simpJy crossing State 
lines. 
Interstate matches account for 9.3 percent of the 
total.26  APPENDIX A
PRACfITIONERS INVOLVED IN MATCHES 
SEPTEMBER 1, 1990 - MACH 19, 1992 
TYE OF PRAcrmoNER NUMBER OF  PERCENTAGE OF 
MATCHES  MATCHES 
TOTAL 
954  100. 
Physicians and Dentists  20, 165  96. 
Allopathic Physicians 038 
Allopathic Physician Residents 219 
Osteopathic Physicians 135 
Osteopathic Physician Interns and Residents 
Dentits 
735 
Dental Residents
Podiatrits 
2.3 
Psychologists 
Other Health Care DisciplineslPersonnel 
Chiropractors 
Optometrts 
Physician Assistants
Podiatrc Assistants
Professional Counselors(cid:1)
Professional Counselors, Family/Marrge(cid:1)
Nurses and Related
Regitered (Professional) Nurses 
Nurse Anesthetits
Nurse Midwives 
Psychiatrc Technicians
Emergency Care Personnel 
Rehabiltation!estorative Servce Personnel
Technicians and Technologists
Not Properly Coded 
178 
DATA SOURCE: National Practitioner Data Bank. ANALYSIS: HHS Offce of Inspector General  . - -
ApPENDIX B

QUERIERS INVOLVED IN MATCHES 
SEPTEMBER 1, 1990 - MACH 19, 1992 
TYE OF QUERIER  NUMBER OF MATCHE  PERCENTAGE OF 
MATCHE 
TOTAL  954  100. 
Non-Federal Hospital  788  89. 
Initial privilegig/employ,,,mt  6,278 
Mana/ory two-year review  12,164 
Professional review activity  301 
Other
Slate Licensing Board:
HMO/pPO  319  6.3 
Initial privilegig/employment  776 
Mana/ory two-year review  158 
Professional review activity  350 
Other 
Other Non-Federal Health Care Entity  382  1.8 
Inil 
privilegig/emploYl1nl  257 
Mana/DIY two-year review  III 
Professional review activity 
Other
State Licensing Board:
Federal Hospital  334  1.6 
Initial privileging/emploYl1nt  202 
Mandatory two-year review  127 
Professional review activity 
State Licensing Board  0.3 
Stale licensing board 
Mandatory two-year review 
Inital privilegig/employment. 
Group Practice 
Professional Socety 
Other Federal Health Care Entity 
DATA SOURCE: National Practitioner Data Bank. ANALYSIS: HHS Offce of Inspector General 
Denotes inconsistency between queryng entity ty and query ty; could result from improper form completion
ty 
or incorrect asignment of entity  code. APPENDIX C
MAPRACTICE PAYMENT RECORDS INVOLVED 
IN MATCHES 
SEPTEMBER 1, 1990 - MACH 19, 1992 
TYE OF  NUMBER OF  PERCENTAGE OF  PERCENTAGE OF
ACT/OMISSION  . MATCHE  MAPRACTCE 
ALL MATCHES 
RECORD 
MATCHES 
TOTAL MATCHES 
954 
100. 
TOTAL 
521  100.  88.4 
MAPRACTCE 
MATCHES 
Surgery-Related 
871  31.7  28. 
Diagnosis-Related 
125  27.  24. 
Treatment-Related  440 
18.  16.4 
Medication-Related 
335 
6.4 
Obstetrics-Related  286 
Anesthesia-Related  583 
Monitoring-Related  235 
Intravenous and Blood  220 
1.2  1.0 
Products-Related 
Miscellaneous 
206 
1.0 
Biomedical Equipment/ 
121 
Product-Related 
Not Properly Coded 
0.5 
DATA SOURCE: National Practitioner Data Bank. ANALYSIS: HHS Offce of Inspector General 
Malpractice payment reports can be given one or two codes indicating 
act or omission. Of the 18 
malpractice payment matches only 4 088 were asigned two codes. For clarittyy,  tohfe s secondary codes  521
disregarded in this table.  have been
C - 1  MAPRACTCE PAYMENT RECORDS INVOLVED IN MATCHES
SEPTEMBER 1, 199 - MACH 19, 1992
(continued) 
MAPRACTCE PAYMENT

NUMBER OF MATCHES PERCENTAGE OF SINGLE
AMOUNT (SINGLE  PAYMENT MAPRACfICE

PAYMENT ONLY)
RECORD MATCHES
TOTAL 
962  100. 
$1 - $29,
 434  37. 
$30 00 - $49  506 
$50 00 - $99  870 
16. 
$100 00 - $499  129  30. 
$500,00 and above  023 
NOTE: Mean = $132 358; Median = $50 00; Mode = $100 
An additional 1 559 matches involved malpractice payments that belonged to a series of 
payments of unknown total value. 
DATA SOURCE: National Practitioner Data Bank. ANALYSIS: HHS Offce of Inspector General 
C - 2  APPENDIX D
ADVERSE ACTION RECORDS INVOLVED IN MATCHES 
SEPTEMBER 1, 1990 - MACH 19, 1992 
TYE OF ADVERSE  NUMBER OF MATCHES  PERCENTAGE OF  PERCENTAGE
ACTON  ADVERSE ACfrON  OF ALL 
MATCHES  MATCHES 
TOTAL MATCHES  954  100. 
TOTAL ADVERSE 
2,433  100,  11.6 
ACTON MATCHES
Licensure  256  51.6 
Revocation 
Probation  560 
Suspension  129 
Miscellaneous  515 
Clinical Privileges 1I44  47.  5.5 
Revocation  144 
Suspension  164 
Voluntary Su"ender  222 
Reduction in Prvileges  122 
Other Restrction 113 
Deninl
 292 
Revision to Action

Professional Society 1.4 
Membership 
Revocation

Suspension

Denial

Not Properly Coded

D - 1  ADVERSE ACfION RECORDS INVOLVED IN MATCHES 
SEP1EMBER 1, 199 - MACH 19, 199 
(continued) 
REASON FOR NUMBER OF MATCHES PERCENTAGE OF  PERCENTAGE 
ACfION ADVERSE ACfION  OF ALL 
MATCHES  MATCHE 
TOTAL MATCHES  954  100. 
TOTAL ADVERSE 
 2,433  100.  11.6 
ACION MATCHES

Alcohol and Other 238
Substance Abuse 
Incompetence/Mal  380  15.  1.8
practice/Negligence
Narcotics Violations
0.4
Felony
1.2
Fraud
Unprofessional Conduct 263 10.  1.3
Mental Disorder
Allowing Unlicensed
Person to Practice 
Disciplinaty Action  127
Taken in Another State
Physical Impairment
0.5
Other Reason--NOI 594 24.4
Classified
Miscellaneous Actions 603 24.
Not Properly Coded
1.4
General Code Used
DATA SOURCE: National Practitioner Data Bank. ANALYSIS: HHS Offce of Inspector General
Reporters use this code when none of the aboe categories apply.
ty 
Misellaneous licensure actions are not asigned clasification codes to parallel other  of actions. The 
breakdow of misllaneous licensure action matches is as follow: License RestOred or Reinstated, 82 matches;
Reinstatement Denied, 5; Reprimand, 176; Other (Including Censure and Surrender), 249; License Denied (Renewal 
Only), 1 and Not Properly Coded, 2. In addition, there were 87 matches related to revisions to actions on hospital 
clinical privleges and 1 related to a revision to action on profesional soiety membership.
D - 2 APPENDIX E 
NOTES 
Health Care Quality Improvement Act of 1986 (P.
L. 99-660), Section 402. 
Adverse actions include licensure revocation, suspension, and probation; clinical 
privilege revocation, suspension, reduction, restriction, and voluntary surrender; 
and professional society membership revocation, suspension, and denial; as well 
as other categories. Some of these other categories include actions favorable to 
practitioners, such as license reinstatement. 
Under current law, State licensing boards must report actions only against 
physicians and dentists, whereas other entities must report actions against 
physicians and dentists and may report actions against other licensed health 
care practitioners. 
Malpractice insurers do not submit reports of payments on behalf of facilties 
or corporations. 
Health care entities must provide health care servces and engage in 
professional review activity through a formal peer review process. 
There are no Federal penalties assessed against hospitals for not querying the 
Data Bank; however, their failure to query could be used against them in legal 
proceedings. 
Presentation by Unisys project director at the National Practitioner Data Bank 
Executive Committee Meeting, Alexandria, VA, December 5, 1991. 
An exact figure is not available. The match count of 9 261 reported as of 
November 22, 1991, includes match types that do not fit the criteria used for 
this report. For example, it includes matches resulting from duplicate reports 
and queries. 
Some tyes of matches were excluded from the computer file. These were self-
queries, in which practitioners requested their own Data Bank records, and 
matches on reports that were later voided  (i.  removed from the Data Bank 
because of errors). 
The file we received from Unisys contained individual records for queries and 
reports. Included in each record was a field for "Practitioner Identification 
Number (PIN)." To construct our fie of matches, we created a new data set 
containing a single record for each request-report pair that named the same 
PIN. 
E - 1  We made two assumptions regarding the file received from Unisys. The first 
was that the PIN in each record was correct, meaning that only queries and 
reports referring to the same individual were paired. The second is that, with 
the exceptions noted above, the file did in fact contain the entire set of 
practitioners for whom both a report and a query had been received. 
SAS Institute, Cary, NC
, 1988. 
10.  Unisys also excluded reports sent to practitioners queryng about themselves
from the data base we received, but we do not know how many times this 
occurred. As of January 1992, the number of self-queries was 117. We 
estimate that there were between 125 and 200 self-queries excluded from the 
data base. 
The originaJ data set obtained from Unisys consisted of 23 153 matches, not 
counting matches on reports later deleted from the Data Bank. Of these, 260
were echoes 756 were from duplicate queries, and 183 were from duplicate 
, 1 
reports. Therefore, 20 954 (90.5 percent) of the 23 153 original matches met 
our criteria for inclusion in the analysis. 
12.(cid:1) Cumulative Data Bank Statistics Summary, presented by Unisys project director 
at December 5, 1991, National Practitioner Data Bank Executive Committee 
Meeting, Alexandria, VA. 
13.(cid:1) Partial matches are cases when more than one, but not all identifyng fields 
match. 
14.  Conversation with HRSA project officer, March 26, 1992.
15.(cid:1) The number of matches is greater than the number of practitioners because
practitioners could have been mentioned in more than one report or could have
been queried about more than once.
16.(cid:1) Our data on cumulative Data Bank reports and queries is drawn from the 
Cumulative Data Bank Statistics Summary, presented by Unisys project director 
at the December 5, 1991, National Practitioner Data Bank Executive 
Committee Meeting, Alexandria, VA. Because the primary purpose of our 
data request was to generate a sample of queriers who had experienced 
matches, we asked for the most recent data available rather than data available 
as of November 22, 1991. The analyses of reports and queries that were 
conducted on November 22, 1991, were not available for the period ending 
March 19, 1992. Our comparisons between the universe of matches and the 
universe of all reports and queries must be interpreted with this in mind. 
17.(cid:1) At the December 5, 1991 , Data Bank Executive Committee meeting, heads of 
national organizations of licensing boards mentioned several reasons for not 
queryng the Data Bank. These include cost, limited history in the Data Bank 
E - 2 and duplication with the national organizations' own data bases. Certainly, as 
the Data Bank ages, it will have more complete historical information and wil 
likely be more attractive to the optional users. 
18.(cid:1) The remaining 0.2 percent of hospital matches were from queries marked as 
state licensing board (4 matches), or other (42 matches). This indicates that 
some hospitals may not be sure which of the "query tye" boxes on the query 
form they should check, or that some non-hospitals were inappropriately 
assigned identification numbers in the hospital category. 
19.(cid:1) The number of matches is greater than the number of reports because multiple 
queriers can match on the same report. 
20.  See note 16 above. 
21.(cid:1) These calculations are based only on the 16 962 matches involving one-time 
payments. Excluded are 1 559 matches involving payments that were part of a 
series of installments, and for which the total payment amount was not 
available. 
22.  There has been recent discussion of imposing a floor dollar amount on 
malpractice payment reports, which would eliminate reports for payments 
under the floor. The Physicians Insurance Association of America has 
recommended a floor of $50 000, while the American Medical Association has 
proposed a floor of $30 000 (Letter from the Chairman of the PIA Data 
Sharing Project to the Director of the Bureau of Health Professions, HRSA on 
February 25, 1991). A $30 000 floor would have eliminated 37.9 percent of the 
matches, and a $50 000 floor would have eliminated another 8.9 percent 
(appendix C). This subject is covered more fully in our report titled "National 
Practitioner Data Bank: Malpractice Reporting Requirements " OEI-01-90-
00521, April 1992. 
23.(cid:1) One report mistakenly gave 1908 as the date of the incident. This report 
generated a match for seven different queries. 
24.  See note 16 above. 
25.(cid:1) The coding system for classes of and reasons for adverse actions was taken 
from the National Practitioner Data Bank reporting instructions. 
26.(cid:1) A match was considered to be an interstate match if the querier s State was 
different from either the practitioner s work State or, for adverse actions, the 
reporter s State. We did not use the reporter s State for malpractice payment 
matches because many physicians are insured by out-of-State companies. 
E - 3