Medical Practice Profiling: Concepts and Caveats

Abstract

Medical practice profiling has gained prominence in recent years as insurance companies, managed care organizations, and government agencies have used and promoted this method of analyzing medical practices. Surprisingly, however, a conceptual basis for profiling-even a clear definition-has been lacking. The present article supplies the missing conceptual foundation and offers an in-depth discussion of the strengths and limitations of the profiling method. The article explains and critiques various measures of medical practice, discusses alternative data sources, provides a framework for evaluating data quality, and addresses key analytical issues concerning the proper use of data for profiling. The objective is to help administrators, researchers, policymakers, patients, physicians, and others interested in profiling understand this genre of analysis so that they will be better equipped to evaluate its results.