Regional variations in the use of common surgical procedures: Within and between England and Wales, Canada and the United States of America

The Prevalence of Low Bone Mineral Density in Dutch Perimenopausal Women: The Eindhoven Perimenopausal Osteoporosis Study

“…Nevertheless, the use of estrogens decreased this risk. The number of hysterectomies varies greatly in different countries [16,17], reflecting local gynaecological practices rather than absolute indications for performing the operation [18]. Our findings, though not definite, suggest that an increased risk of osteoporosis may be considered a potential complication of this operation in young women, which can be, however, reduced by estrogen use.…”

Hierarchical Linear Model Approach to the Determinants of Activities of Daily Living of Chinese Oldest Old at Both Individual and Regional levels

“…On the other hand, increases in income inequality are highly linked to the lack of investment in physical capital, human capital, and cultural capital, which would reap poor outcomes (Smith, 1996). In medical practice style/access model, numerous studies tum out that marked geographic variations in medical care utilization rates are correlated with population healthy status (Chiswick, 1976), and geographic patterns of service utilization rates are much more highly associated with measures of physician and hospital bed supply (Mcpherson et al, 1981 ). Although it is not clear whether geographic variations in medical use are related with ADL of the elderly, we could confer that individuals who live in areas with intense medical practice style would receive professional and comprehensive medical care (Porell and Miltiades, 2002), which does good to maintaining ADL ability of the elderly in the long-term perspective.…”

Overtreatment in Surgery: Discussion Paper

“…That is, the number of operations performed per head of population may vary between communities. Hernia repair, tonsillectomy, cholecystectomy, prostatectomy, haemorrhoidectomy, hysterectomy, and other operations show considerable variation in numbers performed per head of population both between and within some countries (Pearson et al 1968, Lewis 1969, Bunker 1970, Wennberg & Gittelsohn 1973, McPherson et al 1981.…”

“…Cholecystectomy rates are five times higher in Canada than in the United Kingdom (Vayda 1973), but there is no evidence from autopsy or other studies that the prevalence of gallstones is significantly higher (Brett & Barker 1976). However, there is evidence that variations in operating rates between countries and to a lesser extent within countries are related to the availability of surgical resources, particularly manpower (Lewis 1969, Bunker 1970, Wennberg & Gittelsohn 1973, McPherson et al 1981. Also, the nature of the health care system, especially the method of professional payment, may affect surgical rates.…”