Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-15T04:30:59.428Z Has data issue: false hasContentIssue false
  • English
  • Français

International Variation in Intervention Rates: What Are the Implications for Patient Selection?

Published online by Cambridge University Press:  10 March 2009

Nick Black ,
Mark E. Glickman ,
Jiao Ding  and
Ann Barry Flood
Nick Black
Affiliation:
London School of Hygiene and Tropical Medicine
Mark E. Glickman
Affiliation:
Harvard Medical School
Jiao Ding
Affiliation:
Dartmouth Medical School
Ann Barry Flood
Affiliation:
Dartmouth Medical School
Get access Rights & Permissions [Opens in a new window]

Abstract

While international variations in intervention rates are well recognized, little is known about their implications for patient selection. This paper describes an exploratory study in which the probability of undergoing an elective intervention (surgery for benign prostatic hyperplasia) in an area in the United Kingdom was compared with an area in the United States. It found that the area with high intervention rates was associated with higher levels of surgery in men with low levels of need who are unlikely to gain much benefit.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 11 , Issue 4 , Fall 1995 , pp. 718 - 732
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Abrams, P. H., & Feneley, R. C. L.The significance of the symptoms associated with bladder outflow obstruction. Urology International, 1978, 33, 171–74.CrossRefGoogle Scholar
2.Barry, M. J., Cockett, A. I. K., Holtgrewe, H. L., et al. Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. Journal of Urology, 1993, 150, 351–58.CrossRefGoogle ScholarPubMed
3.Barry, M. J., Fowler, F. J., O’Leary, M. P., et al. The American Urological Association Symptom Index for benign prostatic hyperplasia. Journal of Urology, 1992, 148,1549–57.CrossRefGoogle Scholar
4.Barry, M. J., Fowler, F. J., O'eary, M. P., et al. Correlation of the American Urological Association Symptom Index with self-administered versions of the Madsen-Iversen, Boyarsky and Maine Medical Assessment Program symptom indexes. Journal of Urology, 1992, 148, 1558–63.CrossRefGoogle Scholar
5.Bickel, P. J., & Doksum, K. A.Mathematical statistics: Basic ideas and selected topics. Holden-Day Inc., San Francisco, 1977.Google Scholar
6.Bunker, J. P.Surgical manpower: A comparison of operations and surgeons in the United States and in England and Wales. New England Journal of Medicine, 1970, 282, 135–44.CrossRefGoogle ScholarPubMed
7.Chute, C. G., Panser, L. A., Girman, C. J., et al. The prevalence of prostatism: a population-based survey of urinary symptoms. Journal of Urology, 1993, 150, 85–89.CrossRefGoogle ScholarPubMed
8.Emberton, M., & Ellis, B. W.Clinical information system that enhances the use of resources in endoscopic prostatic procedures. British Journal of Urology, 1992, 70, 634–40.CrossRefGoogle ScholarPubMed
9.Epstein, R. S., Deverka, P. A., Chute, C. G., et al. Validation of a new quality of life questionnaire for benign prostatic hyperplasia. Journal of Clinical Epidemiology, 1992, 45, 1431–45.CrossRefGoogle ScholarPubMed
10.Flood, A. B., Black, N. A., McPherson, K., et al. Assessing symptom improvement following elective prostatectomy for benign prostatic hypertrophy. Archives of Internal Medicine, 1992, 152, 1507–12.CrossRefGoogle Scholar
11.Fowler, F. J., Wennberg, J. E., Timothy, R. P., et al. Symptom status and quality of life following prostatectomy. Journal of the American Medical Association, 1988, 259, 3018–22.CrossRefGoogle ScholarPubMed
12.Guess, H. A.Benign prostatic hyperplasia: Antecedents and natural history. Epidemiologic Reviews, 1992, 14, 131–53.CrossRefGoogle ScholarPubMed
13.Guess, H. A., Chute, C. G., Garraway, W. M., et al. Similar levels of urological symptoms have similar impact on Scottish and American men, although Scots report less symptoms. Journal of Urology, 1993, 150, 1701–05.CrossRefGoogle ScholarPubMed
14.Hunter, D. J. W., McKee, C. M., Black, N. A., & Sanderson, C. F. B.Urinary symptoms: Prevalence and severity in British men aged 55 and over. Journal of Epidemiology and Community Health, 1994, 48, 569–75.CrossRefGoogle ScholarPubMed
15.Hunter, D. J. W., McKee, C. M., Sanderson, C. F. B., & Black, N. A.Appropriate indications for prostatectomy in the UK: Results of a consensus panel. Journal of Epidemiology and Community Health, 1994, 48, 58–64.CrossRefGoogle ScholarPubMed
16.McConnell, J. D., Barry, M. J., Bruskewitz, R. C., et al. Benign prostatic hyperplasia Diagnosis and treatment. AHCPR Publication No. 94-0582. Rockville, MD: Agency for Health Care Policy and Research, Public Health Services, U.S. Department of Health and Human Services, 02 1994.Google ScholarPubMed
17.McPherson, K., Coulter, A., & Stratton, I.Increasing use of private practice by patients in Oxford requiring common elective operations. British Medical Journal, 1985, 291, 797–99.CrossRefGoogle Scholar
18.McPherson, K., Wennberg, J., Hovind, O., & Clifford, P.Small-area variation in the use of common surgical procedures: An international comparison of New England, England and Norway. New England Journal of Medicine, 1982, 307, 1310–14.CrossRefGoogle ScholarPubMed
19.Nicholl, J. P., Beeby, N. R., & Williams, B. T.Role of the private sector in elective surgery in England and Wales, 1986. British Medical Journal, 1989, 292, 243-47.CrossRefGoogle Scholar
20.Pearson, R. J. C., Smedy, B., Berfenstam, R., et al. Hospital caseloads in Liverpool, New England and Uppsala: An international comparison. Lancet, 1968, 2, 559–66.Google ScholarPubMed
21.Roos, N. P., & Roos, L. L.Surgical rate variations: do they reflect the health or socioeconomic characteristics of the population? Medical Care, 1982, 20, 945–58.CrossRefGoogle ScholarPubMed
22.U.S. Census STF3B Zip-code level file. Washington, DC: U.S. Government Printing Office, 1990.Google Scholar
23.Vayda, E. A comparison of surgical rates in Canada and in England and Wales. New England Journal of Medicine 1973, 289, 1224–29.Google Scholar
24.Velleman, P. F., & Hoaglin, D. C.Applications, basics and computing of exploratory data analysis. Boston: Duxbury Press, 1981.Google Scholar
25.Wennberg, J. E.On patient need, equity, supplier induced demand and the need to assess the outcome of common medical practices. Medical Care, 1985, 23, 512–20.CrossRefGoogle ScholarPubMed