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. 2015 Nov 10;5(3):165–172. doi: 10.15171/ijhpm.2015.196

Table 3. The Indicators and the Statistics of Selecting the Clusters Indicating the Physicians Who Were Suspect of Perpetrating Abuse or Fraud .

Indicator Mean SD Mean SD
Abuse detection Cluster 1 – 46%
(75 physicians)
Cluster 2 – 54%
(89 physicians)a
Percentage of the patients that they were visited more than once in a month 16.20 5.46 21.72 11.20
The average of the prescript drug items in a claim 3.54 0.57 4.66 0.57
The average cost of a drug prescription claimb 23827 5398 29668 5662
The ratio of the 5 expensive antibiotic prescription to all physician claims 0.25 0.11 0.39 0.17
The ratio of injection prescription to all physician claim 0.81 0.30 1.53 0.42
The ratio of total injection prescription to all physician claim 1.55 0.74 2.92 0.83
The ratio of total prescript antibiotic to all physician claims 0.68 0.18 1.06 0.19
The ratio of injected antibiotic to physician claim 0.19 0.11 0.44 0.15
The ratio of injected corticosteroid prescription to all physician claim 0.26 0.13 0.48 0.19
Fraud detection Cluster 1 – 98%
(160 physicians)
Cluster 2 – 2%
(4 physicians)a
Percentage of reduplicative patients 30.05 10.58 41.87 15.23
Percentage of reduplicative patients-pharmacy 22.92 10.43 37.49 18.28
Percentage of reduplicative patients-pharmacy in a month 5.70 3.19 10.09 4.88
The average cost of a drug prescription claimb 26656 5902 40613 4756
The ratio of claims referred to a high-cost pharmacy 0.08 0.24 4.16 1.16

a Cluster 2 indicates the suspect group.

b This indicator has been used in the detection of fraud and abuse.