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Variation in Medical Practice: Implications for the Hospital Epidemiologist

Published online by Cambridge University Press:  02 January 2015

Stephen B. Kritchevsky  and
Bryan P. Simmons
Stephen B. Kritchevsky*
Affiliation:
Department of Preventive Medicine, University of Tennessee, Memphis, Memphis, Tennessee
Bryan P. Simmons
Affiliation:
Methodist Hospitals of Memphis, Memphis, Tennessee
*
Department of Preventive Medicine, Division of Biostatistics and Epidemiology, University of Tennessee, Memphis, 877 Madison Ave., Memphis, TN 38163
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Extract

Why do two physicians faced with similar patients make different decisions about the care their patients should receive? This area of health services research has been energized by recent concerns about rising healthcare costs. In 1982, Wennberg and Gittelsohn described the great variation in surgical procedure rates throughout the northeastern United States during the 1970s. Population rates of hysterectomy and prostatectomy varied fourfold between local service areas; tonsilectomy rates varied sixfold. Differences in patient populations could not explain the variation in rates. The authors concluded that a large portion of the variability was attributable to the personal preferences of the surgeons practicing in the various communities. Similar differences in procedure rates are easy to replicate and are evident at several levels of aggregation. On larger scales, regional and international differences can be documented easily. On a smaller scale, practice variation within individual hospitals is frequently evident.

Type
Beyond Infection Control: The New Hospital Epidemiology
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 2 , February 1994 , pp. 116 - 119
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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References

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