Previous research casts doubt on value of NPDB
The latest report from the federal government questions the value of information in the National Practitioner Data Bank (NPDB), but it is not the first time doubts have been raised. One study in 1999 suggested that the data found in the data bank were incomplete. The authors of the study noted that the NPDB is believed to be an important source of information for peer review activities by the majority of those who use it.1
The researchers conducted a 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. A total of 4,743 short-term, nonfederal, general medical/surgical hospitals throughout the United States were continuously open between 1991-1995 and registered with the NPDB. The researchers investigated how many hospitals reported one or more privileges actions during the five-year study period, as well as privileges action reporting rates (numbers of actions reported per 100,000 admissions).
They found that hospitals reported 3,328 privileges actions between 1991 and 1995; 34.2% reported one or more actions during the period. The range of privileges action reporting rates for these hospitals was 0.4 to 52.27 per 100,000 admissions, with an overall rate of 2.36 per 100,000 admissions. The proportion of hospitals reporting an action decreased from 11.6% in 1991 to 10% in 1995.
After adjustment for other factors, urban hospitals had significantly higher reporting than rural hospitals. There were notable regional differences in reporting, with the east south central region having the lowest rate per 100,000 admissions (1.49).
"The results of this study indicate a low and declining level of hospital privileges action reporting to the NPDB," the researchers concluded. "Several potential explanations exist, one of which is that the information reported to the NPDB is incomplete."
Reference
1. Baldwin LM, Hart GL, Oshel RE, et al. Hospital peer review and the National Practitioner Data Bank. JAMA 1999; 282:349-355.
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