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At least 19 recordsLinked to original sources
PubMed1995

Physician understanding of the National Practitioner Data Bank.

National Practitioner Data Bank (NPDB) reports are part of the process for acquiring staff privileges, professional credentials, and licenses throughout a physician's entire career. We surveyed our hospital's 66 residents to assess their understanding of NPDB. Only 9 residents had heard about NPDB. A follow-up survey of the 10 medical schools in Pennsylvania and Maryland showed just 4 schools covered NPDB in their curricula. Finally, we did a third survey--of 1,410 Pennsylvania Medical Society members. Eighty-one percent did not know that denial of initial license application was not a reportable offense; 69% did not know that voluntary entrance into alcohol/drug rehabilitation was not reportable; and 75% did not know that denial of expanded privileges because of level of clinical competence was reportable. Only 13% knew how to obtain their files. Our surveys suggest physicians have a poor understanding of NPDB even though these reports could have career-jeopardizing implications, especially if the Clinton administration expands access to NPDB.

Adult↗
PubMed1995

Malpractice data from the National Practitioner Data Bank.

The National Practitioner Data Bank (NPDB) is a computer depository of healthcare providers' malpractice payments by insurers and adverse actions by licensing boards, hospitals or professional societies accumulated since September 1, 1990. The NPDB provides a resource for health care entities to query before hiring healthcare providers with the hope of identifying possible incompetent practitioners. The statistics isolating physician and nursing malpractice payment used in this article were obtained from Senator Inouye who requested their compilation from the Department of Health and Human Services. An examination of the NPDB malpractice payment reports to 1993 for Registered Nurses (RN), Advanced Practice Nurses (APN), and physicians shows that RNs and APNs are reported much less frequently than physicians. This article presents the raw and rate data, discusses accuracy of the data, and presents implications for APNs.

Databases, Factual↗
PubMed2003

How useful is the information provided by the National Practitioner Data Bank?

BACKGROUND: The National Practitioner Data Bank (NPDB) serves as a federal information clearinghouse on malpractice payments for and disciplinary sanctions against health care practitioners. Hospitals are required to query the NPDB biannually for practitioners with clinical privileges, and other health care entities with significant peer review are encouraged to query the NPDB. A study was conducted to determine whether health care organizations find the NPDB useful. METHODS: A survey was conducted of 1,038 organizations that queried the NPDB between March 1998 and February 1999; 653 of those respondents also answered questions regarding 1,639 specific matched responses (feedback from the NPDB when the practitioner in question had one or more reports). RESULTS: Overall, the entities rated querying the NPDB as very useful (6.16 on a 7-point scale). More than 21% of matched responses contained new information, and this information altered institutional credentialing decisions in more than 5% of the cases. DISCUSSION: Many of the results from this study are consistent with findings in Office of Inspector General reports. The fact that 5% of credentialing decisions were altered because of NPDB information suggests that practitioner self-report is an inadequate mechanism for soliciting credentialing information. SUMMARY AND CONCLUSIONS: NPDB reports provide accurate and complete information that is useful to providers in their credentialing process.

Attitude of Health Personnel↗
PubMed1992

The National Practitioner Data Bank: an introduction.

The National Practitioner Data Bank, mandated by law, has created a great deal of anxiety in the medical community. The author describes the origin, development, and operation of the bank. Army implementation procedures emphasize safeguards for practitioners and are also felt to be fully consistent with patient protection. Potential problems and areas for further research are described. Linking practitioner entry to standard of care or setting a dollar cut-off for entries are two possible solutions.

Databases, Factual↗
PubMed1991

Avoiding traps and pitfalls in National Practitioner Data Bank compliance.

Quirks in the National Practitioner Data Bank regulations and operations may catch medical staffs and hospitals unawares, creating potential traps and pitfalls that could result in exposure to lawsuits and federal sanctions. In this article, the author outlines several areas of possible difficulty and offers tips to help medical staffs avoid problems in these areas.

Allied Health Personnel↗
PubMed1991

Implications of the National Practitioner Data Bank for nurse practitioners.

The National Practitioner Data Bank is a new federal repository of data on malpractice payments and adverse actions taken against the clinical privileges and licenses of all health care practitioners. This article summarizes the law governing the data bank and its implications for nurse practitioners. Specific reporting requirements are discussed, as well as guidelines for those who must and those who can access the data bank. This article also explains how NPs are notified when reports are made and gives methods for correcting errors in reports.

Data Collection↗
PubMed2000

The National Practitioner Data Bank: coping with the uncertainties.

The National Practitioner Data Bank is a database of adverse events involving physicians and other practitioners. Querying the database is mandatory for hospitals in several situations. So too, hospitals are required to report specified adverse events. Thus, hospitals need to be able to identify incidents that are reportable events, events that require them to update the databases, and any possible liability issues that may surround the hospital's reporting duties. The author argues that the regulations are unclear in addressing these issues. Likewise, he notes that practitioners should be aware of other problems with the reporting system, including the lack of sufficient Data Bank security.

Clinical Competence↗
PubMedDate not supplied

The National Practitioner Data Bank: the first 4 years.

The National Practitioner Data Bank became operational September 1, 1990, as a flagging system to identify health care practitioners who may have been involved in incidents of medical incompetence. Query volumes have grown substantially over the Data Bank's first 4 years of operation. The greatest increase has come in the number of voluntary queries. By the end of 1994, the Data Bank had processed more than 4.5 million requests for information on practitioners, more than 1.5 million of which were received in 1994 alone. The proportion of queries for which the Data Bank contains information on the practitioner in question has grown as the Data Bank has come to contain more reports. During 1994, 7.9 percent of queries were matched. The Data Bank contained more than 97,500 reports at the end of 1994. More than 82 percent of the reports concerned malpractice payments. Licensure reports made up the bulk of the rest. Physicians predominate in reports, accounting for slightly more than 76 percent of the total. The remainder are related to dentists (16 percent) and all other types of practitioners (8 percent). Since reporting of adverse actions is mandatory only for physicians and dentists, the proportion of reports attributable to these types of practitioners is higher than it would be if adverse action reporting requirements were uniform for all practitioners. State malpractice payment rates and adverse action rates vary widely, but a State's rate in any given year is highly correlated with its rate in any other year. State malpractice rates are not strongly correlated with adverse action rates, neither are the rates for physicians strongly correlated with those for dentists. There is a weak tendency for States with smaller physician populations to have higher levels of licensure and privileging actions.

Allied Health Personnel↗
PubMed1998

The National Practitioner Data Bank: implications for nurse anesthetists.

The National Practitioner Data Bank (NPDB), created by the 1986 Health Care Quality Improvement Act, has been in operation since 1990. Hospitals and other credentialing bodies must query the NPDB when granting and renewing privileges. The NPDB receives about 25,000 reports of adverse actions against health practitioners each year. The NPDB was designed to be a flagging system providing information to licensing or credentialing authorities who would further examine practitioner records. Its purpose is to ensure that decision makers have information that might not otherwise be readily available, especially in the case of incompetent practitioners who move from hospital to hospital or state to state. Access to NPDB information is a concern for consumers and providers alike. Only 2% of matched reports to the NPDB made a difference in hospital privileging decisions. A limitation of NPDB information is that malpractice payments recorded in the NPDB do not necessarily constitute a comprehensive and definitive reflection of actual health care incompetence. All health care providers need to be aware of the NPDB, its mission, potential impact on their ability to be credentialed, and proposed additional uses of its information.

Clinical Competence↗
PubMed1990

The National Practitioner Data Bank. What surgeons should know.

The National Practitioner Data Bank began operation on September 1, 1990, nearly a year after the final regulations for it were published in the October 17, 1989, Federal Register. One of two major provisions of the Health Care Quality Improvement Act (HCQIA) of 1986 (P.L. 99-660), the data bank is expected to have widespread implications for all surgeons and Fellows of the College. This article summarizes the effects it is anticipated the data bank will have on Fellowship and provides a general outline of the regulations that will affect surgeons.

General Surgery↗
PubMed1997

Rural hospitals' experience with the National Practitioner Data Bank.

OBJECTIVES: This study examined hospital administrators' experiences with the National Practitioner Data Bank. METHODS: One hundred forty-nine rural hospital administrators completed questionnaires assessing their perceptions of the data bank. RESULTS: Nearly 90% of respondents rated the data bank as an important source of information for credentialing. Three percent indicated it had directly affected privileging decisions; 43% and 34%, respectively, believed the costs exceeded or equaled the benefits. Twenty percent reported changes that could decrease disciplinary action reports to the data bank. CONCLUSIONS: While the National Practitioner Data Bank is an important source of information to rural hospitals, it may, affect few credentialing decisions and motivate behavioral changes that could have a paradoxical effect on quality assurance.

Consumer Behavior↗
PubMedDate not supplied

Quality of care and the National Practitioner Data Bank: are the two related?

As the National Practitioner Data Bank (NPDB) approaches its tenth year of operation, it is time to review Data Bank operations in comparison to the goals set forth in the legislation that created it, the Health Care Quality Improvement Act of 1986. The goal of the enabling legislation was to improve the quality of health care rendered in this country. The NPDB was created as one step in the achievement of that goal by identifying problem practitioners who may move from one geographic location to another, thus leaving a poor performance record behind. The premise of this article is to review the contributions of the NPDB in terms of accurately identifying practitioners who pose a quality problem.

Clinical Competence↗
PubMed1991

Adapting to the National Practitioner Data Bank: perspectives for physicians.

Now that the National Practitioner Data Bank is fully operational, the reporting requirements and the potential public availability of information contained therein have generated legitimate concern among physicians. This article discusses some of the legal and practical implications of compliance with the requirements and explores possible options for physicians seeking to minimize the risk of triggering the reporting requirements.

Licensure, Medical↗
PubMed1999

Hospital peer review and the National Practitioner Data Bank: clinical privileges action reports.

CONTEXT: The National Practitioner Data Bank (NPDB) is believed to be an important source of information for peer review activities by the majority of those who use it. However, concern has been raised that hospitals may be underreporting physicians with performance problems to the NPDB. OBJECTIVE: To examine variation in clinical privileges action reporting by hospitals to the NPDB, changes in reporting over time, and the association of hospital characteristics with reporting. DESIGN: Retrospective cohort study of privileges action reports to the NPDB between 1991 and 1995, linked with the 1992 and 1995 databases from the Annual Survey of Hospitals conducted by the American Hospital Association. SETTING AND PARTICIPANTS: A total of 4743 short-term, nonfederal, general medical/surgical hospitals throughout the United States that were continuously open between 1991-1995 and registered with the NPDB. MAIN OUTCOME MEASURES: (1) Reporting of 1 or more privileges actions during the 5-year study period and (2) privileges action reporting rates (numbers of actions reported per 100000 admissions). RESULTS: Study hospitals reported 3328 privileges actions between 1991 and 1995; 34.2% reported 1 or more actions during the period. The range of privileges action reporting rates for these hospitals was 0.40 to 52.27 per 100000 admissions, with an overall rate of 2.36 per 100000 admissions. The proportion of hospitals reporting an action decreased from 11.6% in 1991 to 10.0% in 1995 (P=.008). After adjustment for other factors, urban hospitals had significantly higher reporting than rural hospitals (adjusted odds ratio [OR], 1.21 [95% confidence interval [CI], 1.02-1.43]), while members of the Council of Teaching Hospitals of the Association of American Medical Colleges had significantly lower reporting than nonmembers (adjusted OR, 0.54 [95% CI, 0.40-0.73]). There were notable regional differences in reporting, with the east south Central region having the lowest rate per 100000 admissions (1.49 [95% CI, 1.33-1.65]). CONCLUSIONS: The results of this study indicate a low and declining level of hospital privileges action reporting to the NPDB. Several potential explanations exist, 1 of which is that the information reported to the NPDB is incomplete.

Clinical Competence↗
PubMedDate not supplied

The National Practitioner Data Bank: information for and about midwifery.

The National Practitioner Data Bank (NPDB), mandated by federal legislation in 1986, serves as a mechanism to protect the public from unsafe practitioners who attempt to avoid discovery of prior negligent behavior or malpractice record(s) by moving from state to state. Reporting to the NPDB about malpractice payments on behalf of nurse-midwives began in 1990. Reporting of providers excluded from Medicare and Medicaid program participation began in September 1999. Practitioners who were already in an excluded status at that time were reported. Reports of adverse action against a nurse-midwife can be submitted to the NPDB by a state licensure board, a governmental agency, hospitals, health maintenance organizations, or other health care organizations. Reporting of licensing actions and clinical privilege actions are not required, although these may be voluntarily reported. The NPDB received 484 reports about nurse-midwives from September 1, 1999, to March 31, 2005. Of the 484 reports, 375 have an obstetric malpractice code. The median claim payment made on behalf of nurse-midwives during this period is 225,000 dollars. Although limited, the NPDB is the only systematic national source of nurse-midwifery malpractice data collection.

Confidentiality↗
PubMed2006

Reports to the National Practitioner Data Bank involving dentists, 1990-2004.

BACKGROUND: While the National Practitioner Data Bank (NPDB) contains reports relating to dentists, an analysis of these data has not been published. METHODS: The authors analyze 47,441 reports to the NPDB relating to malpractice payments, licensure actions and adverse actions against dentists from Sept. 1, 1990, to Sept. 30, 2004. RESULTS: A total of 13.2 percent of all NPDB reports were related to dentists. Of these, 73.7 percent resulted from malpractice actions and the remaining 26.3 percent were from adverse actions. While the number of large payments increased over this period, the median payment remained relatively stable. CONCLUSIONS: Dental malpractice settlements and judgments generally have kept pace with inflation over the past decade. PRACTICE IMPLICATIONS: Dentists should be aware that the NPDB retains reports of adverse actions and malpractice settlements and judgments indefinitely. These reports are available to hospitals evaluating their credentials, state licensing boards and certain health care entities (for example, health maintenance organizations and preferred provider organizations) entering into an employment or other relationship with them.

Dentists↗
PubMedDate not supplied

The growth of physician medical malpractice payments: evidence from the National Practitioner Data Bank.

We used data from the National Practitioner Data Bank (NPDB) to study the growth of physician malpractice payments. Judgments at trial account for 4 percent of all malpractice payments; settlements account for the remaining 96 percent. The average payment grew 52 percent between 1991 and 2003 (4 percent per year) and now exceeds dollar 12 per capita each year. These increases are consistent with increases in the cost of health care. A preoccupation with data on judgments, extreme awards, or specific specialties results in an incomplete understanding of the growth of physician malpractice payments.

Costs and Cost Analysis↗
PubMed1990

Problems of the National Practitioner Data Bank.

After a two-year delay, the National Practitioner Data Bank, authorized by the Health Care Quality Improvement Act of 1986, has yet to begin its mission to collect and disseminate information concerning adverse actions affecting physicians' hospital privileges, licensure, and malpractice claims experience. This article discusses some of the problems that are likely to arise in the operation of the Data Bank.

American Medical Association↗