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Medical Practice Variations

  • Reference work
  • © 2016

Overview

  • Raises critical concerns about the quality, equity and efficiency of international health care resources
  • Synthesizes current research on variations in healthcare utilization, delivery and outcomes
  • Outlines established concepts & frameworks involved in researching medical practice variations
  • Examines systemic questions about healthcare spending, decision-making and service disparities
  • Includes supplementary material: sn.pub/extras

Part of the book series: Health Services Research (HEALTHSR)

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Table of contents (23 entries)

Keywords

About this book

This title deals with internationally documented variations in medical practice and health service that exist across countries as well as regions across a specific country. Such variations raise critical concerns about the quality, equity and efficiency of health care resources across the world. Health services researchers have long been aware of large variations in the use of medical care across regions and medical providers. In the 1930s, the British pediatrician J.A. Glover observed that the rates of tonsillectomy in British schoolchildren varied widely, depending on the district where the students lived and the doctors who examined them. This volume provides a contextual landscape for the study of health care utilization through the lens of medical practice variations. It is grounded in the pioneering work by medical care epidemiologist, Dr. John Wennberg, who revealed wide variations in elective surgical rates across small areas in the U.S. and his findings that these variations were generally not explained by differences in population illness rates or patient preferences but rather, there were strong associations between supply of health care resources, such as hospital beds and physicians and health care utilization.

This volume introduces the concept of medical practice variations and its early history, outlines established concepts and frameworks, with an overview of methods used to understand the variations in medical care

. It makes the case for outcomes research in determining what works in health care and policy reforms to rationalize how care is delivered. Each chapter synthesizes the current published literature in the field and covers a description of medical practice variations in the area, determinants of these variations and outcomes. It outlines the most current research on specific types of utilization such as inpatient care, emergency services, elective surgery, primary care, obstetric and gynaec

ological care, mental health care and end-of-life care, among others. Studies of variation in condition-specific care focus on common conditions such as acute myocardial infarction, congestive heart failure, stroke, diabetes and procedures such as cancer surgery and joint replacement. Special topics include health care spending and quality, shared decision making and disparities.

Editors and Affiliations

  • DptofPublHlthSci,InstfrClnclEvltSciQueen, CntrforHlthServs&PolicyRsrch,Queen'sUniv, Kingston, Canada

    Ana Johnson

  • Institute forClinical EvaluativeSciences, Toronto, Canada

    Thérèse A. Stukel

About the editors

Thérèse Stukel is Senior Scientist at the Institute for Clinical Evaluative Sciences (ICES) in Toronto, ON Canada.

Ana Johnson is Professor in the Department of Public Health Sciences at Queen's University, Kingston, ON Canada. She is also the Site Director of the Institute for Clinical Evaluative Sciences (ICES).

Bibliographic Information

  • Book Title: Medical Practice Variations

  • Editors: Ana Johnson, Thérèse A. Stukel

  • Series Title: Health Services Research

  • DOI: https://doi.org/10.1007/978-1-4899-7603-1

  • Publisher: Springer New York, NY

  • eBook Packages: Medicine, Reference Module Medicine

  • Copyright Information: Springer Science+Business Media New York 2016

  • Hardcover ISBN: 978-1-4899-7602-4Published: 22 March 2016

  • eBook ISBN: 978-1-4899-7603-1Published: 21 March 2016

  • Series ISSN: 2511-8293

  • Series E-ISSN: 2511-8307

  • Edition Number: 1

  • Number of Pages: XIX, 517

  • Number of Illustrations: 67 b/w illustrations, 16 illustrations in colour

  • Topics: Health Administration, Health Care Management, Epidemiology, Quality of Life Research

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