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Medical Care Research and Review, Vol. 59, No. 2, 184-196 (2002)
DOI: 10.1177/1077558702059002004

Measuring Deception: Test-Retest Reliability of Physicians’ Self-Reported Manipulation of Reimbursement Rules for Patients

Jonathan B. VanGeest

American Medical Association

Matthew K. Wynia

American Medical Association

Deborah S. Cummins

American Medical Association

Ira B. Wilson

New England Medical Center

This study examined the test-retest reliability of physicians’ self-reported manipulation of reimbursement rules for patients. The test-retest reliability of self-report of three specific tactics were examined: (1) exaggerating the severity of patients’ conditions, (2) changing a patient’s official (billing) diagnosis, and (3) reporting signs or symptoms that patients did not have. The reliability of a scaled summary measure of physicians’manipulation of reimbursement rules was also assessed. Overall, the authors found high levels of test-retest agreement across all three items and the summary measure. These findings suggest that self-report can be used to produce reliable data on this controversial issue. Specifically, the three items reported here can be used to produce a reliable summary measure of physicians’manipulation of reimbursement rules to help patients obtain care that physicians perceive as necessary.


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