Variation profiles of common surgical procedures

An overview of quality and safety in health care

“…46,47 For example, Birkmeyer et al showed the ratio of the highest to the lowest hospital referral regions for carotid endarterectomy for Medicare enrollees in the USA to be approximately 10 to 1. 46 Variation based on differences between patients is appropriate, but this variation was not explained by case mix or even by differences in resource.…”

“…46,47 For example, Birkmeyer et al showed the ratio of the highest to the lowest hospital referral regions for carotid endarterectomy for Medicare enrollees in the USA to be approximately 10 to 1. 46 Variation based on differences between patients is appropriate, but this variation was not explained by case mix or even by differences in resource. Instead, variation of this type seems typically to reflect regional differences in the approach of providers, 46,48 although prejudice on one hand and patient preferences on the other may also be factors.…”

“…46 Variation based on differences between patients is appropriate, but this variation was not explained by case mix or even by differences in resource. Instead, variation of this type seems typically to reflect regional differences in the approach of providers, 46,48 although prejudice on one hand and patient preferences on the other may also be factors. [49][50][51] Areas receiving the greatest investment in health care or the most interventions do not necessarily have the best outcomes.…”

“…46,47 Par exemple, Birkmeyer et coll. ont montré que l'incidence de consultations pour une endartériectomie carotidienne pour les patients inscrits à Medicare aux É tats-Unis variait d'un facteur d'à peu près 10 entre la région ayant la plus grande incidence et celle dont l'incidence était la plus faible.…”

“…ont montré que l'incidence de consultations pour une endartériectomie carotidienne pour les patients inscrits à Medicare aux É tats-Unis variait d'un facteur d'à peu près 10 entre la région ayant la plus grande incidence et celle dont l'incidence était la plus faible. 46 La disparité fondée sur les différences entre patients est adaptée, mais cette variation ne s'explique pas par la clientèle ou par des différences en matière de ressources. Plutôt, ce type de variation semble refléter des différences typiquement régionales au niveau de l'approche des professionnels, 46,48 bien que les préjugés d'une part et les préférences des patients d'autre part puissent également être des facteurs.…”