Regional variation in medical care

Article Abstract:

Studies on variation in the use and effectiveness of medical procedures should be interpreted with caution, but these studies may lead to health care improvement. According to some studies, the use of medical procedures varies between geographic regions, physicians, and patients. These variations are due to differences in health care systems, physicians' beliefs and skills, and patients' attitudes. Some studies have documented variation in the outcome of procedures between regions and physicians. Such evaluative studies may not sufficiently adjust for differences in patients' initial conditions. Patient condition may affect outcome regardless of quality of care. Thus studies that evaluate care in different regions and by different doctors must be interpreted cautiously. However, studies of variation in medical care are of concern to patients, managers of health care systems, and physicians.

Editorial, Demographic aspects

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What is appropriate care?

Article Abstract:

The RAND-UCLA Delphi panel method is often used to determine when medical care is appropriate and when it is not. It uses panels of experts to analyze the use of medical procedures under various conditions. However, doctors who have analyzed this method say the ratings vary depending on the specialty and nationality of the members of the panel. A 1999 report found a wide discrepancy among expert panels when deciding when hysterectomy is appropriate. This often happens when there is little scientific evidence to support the use of a procedure.

Evaluation, Medical care utilization

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Canada's health care system -- reform delayed

Article Abstract:

A summary of the issues facing the Canadian health care system since 2000 is presented. A discussion of the Romanow and Kirby reports and the First Ministers' Health Care Renewal Accord of 2003 is included. Canada has a universal health care system where the federal government shares the cost of health care.

Canada, Administration of Public Health Programs, National Health Insurance

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