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  1. Confidentiality and health insurance fraud.

    Article, Communication - En anglais

    Annual Meeting of the Society of General Internal Medicine. Washington, DC (USA), 1996/05/04.


    Health insurance fraud committed by patients may be an increasing problem given the number of underinsured and uninsured people in the United States.

    Physicians recognizing acts of health insurance fraud perpetrated by patients face an ethical dilemma : should they disclose the incident to the insurance company, or protect patient confidentiality ?


    To explore physicians'attitudes toward the reporting of patient-initiated health insurance fraud.


    Three hundred seven physician members of the American College of Physicians returned a mailed questionnaire that presented 6 case vignettes (3 variables) of patients who used a relative's insurance to obtain health care in the past.

    For each vignette, respondents were asked whether the treating physician should report insurance fraud to the health insurance carrier.


    Sixty-three respondents (20.7%) indicated that physicians should report all the patients presented in the vignettes, while 45 (14.8%) indicated none should be reported ; the rest indicated that the decisions to report should be based on the characteristics presented, with acute vs terminal illness (P<. 001), history of fraud (P<. 001), and wealth of the patient (P<. 001) all causing physicians to be more likely to report the patient to the health insurance carrier. (...)

    Mots-clés Pascal : Assurance maladie, Confidentialité, Etats Unis, Amérique du Nord, Amérique, Homme, Fraude

    Mots-clés Pascal anglais : Health insurance, Confidentiality, United States, North America, America, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0211788

    Code Inist : 002B30A07E. Création : 21/05/1997.