BIRCH: an efficient data clustering method for very large databases
SIGMOD '96 Proceedings of the 1996 ACM SIGMOD international conference on Management of data
LOF: identifying density-based local outliers
SIGMOD '00 Proceedings of the 2000 ACM SIGMOD international conference on Management of data
Efficient algorithms for mining outliers from large data sets
SIGMOD '00 Proceedings of the 2000 ACM SIGMOD international conference on Management of data
Application of Genetic Algorithm and k-Nearest Neighbour Method in Medical Fraud Detection
SEAL'98 Selected papers from the Second Asia-Pacific Conference on Simulated Evolution and Learning on Simulated Evolution and Learning
Algorithms for Mining Distance-Based Outliers in Large Datasets
VLDB '98 Proceedings of the 24rd International Conference on Very Large Data Bases
Mining medical specialist billing patterns for health service management
AusDM '08 Proceedings of the 7th Australasian Data Mining Conference - Volume 87
AusDM '11 Proceedings of the Ninth Australasian Data Mining Conference - Volume 121
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This paper presents an application of a local density based outlier detection method in compliance in the context of public health service management. Public health systems have consumed a significant portion of many governments' expenditure. Thus, it is important to ensure the money is spent appropriately. In this research, we studied the potentials of applying an outlier detection method to medical specialist groups to discover inappropriate billings. The results were validated by specialist compliance history and direct domain expert evaluation. It shows that the local density based outlier detection method significantly outperforms basic benchmarking method and is at least comparable, in term of performance, to a domain knowledge based method. The results suggest that the density based outlier detection method is an effective method of identifying inappropriate billing patterns and therefore is a valuable tool in monitoring medical practitioner billing compliance in the provision of health services.