Geographic Variation in Expenditures for Physicians' Services in the United States

New England Journal of Medicine

Volumn 328, Issue 9, 1993, Pages 621-627

  Welch, W Pete ^a   Welch, H Gilbert ^b,c   Fisher, Elliott S ^b,c   Wennberg, John E ^c  

^a URBAN INSTITUTE   (United States)

^b VA MEDICAL CENTER   (United States)

^c DARTMOUTH MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; GEOGRAPHY; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH MAINTENANCE ORGANIZATION; HEALTH SERVICE; HOSPITAL ADMISSION; MEDICAL FEE; MEDICAL SPECIALIST; MEDICARE; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; UNITED STATES;

AMBULATORY CARE; CATCHMENT AREA (HEALTH); COMPARATIVE STUDY; DATA COLLECTION; HEALTH EXPENDITURES; HOSPITALIZATION; INSURANCE, PHYSICIAN SERVICES; MEDICARE PART B; PERSONAL HEALTH SERVICES; PHYSICIANS; PHYSICIANS, FAMILY; SUPPORT, U.S. GOV'T, NON-P.H.S.; UNITED STATES;

EID: 0027518577     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJM199303043280906     Document Type: Article

References (23)

1. Himmelstein DU, Woolhandler S, Writing Committee of the Working Group on Program Design. A national health program for the United States: a physicians' proposal. N Engl J Med 1989; 320:102-108
2. Chassin MR, Brook RH, Park RE, Variations in the use of medical and surgical services by the Medicare population. N Engl J Med 1986; 314:285-290
3. Chassin MR, Kosecoff J, Park RE, Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures. JAMA 1987; 258:2533-2537
4. Holahan J, Berenson RA, Kachavos PG Area variations in selected Medicare procedures. Health Aff (Millwood) 1990; 9:166-175
5. Wennberg J, Gittelsohn A Variations in medical care among small areas. Sci Am 1982; 254:120-134
6. Wennberg JE Dealing with medical practice variations: a proposal for action. Health Aff (Millwood) 1984; 3:6-32
7. Wennberg JE, Freeman JL, Culp WJ Are hospital services rationed in New Haven or over-utilised in Boston? Lancet 1987; 1:1185-1189
8. Wennberg JE, Freeman JL, Shelton RM, Bubolz TA Hospital use and mortality among Medicare beneficiaries in Boston and New Haven. N Engl J Med 1989; 321:1168-1173
9. Wennberg JE, Gittelsohn AM Small area variations in health care delivery. Science 1973; 182:1102-1108
10. Mitchell JB Area variation in Medicare physician spending. Health Aff (Millwood) 1992; 11: (1): 224-234
11. Community hospitals, beds, admissions and occupancy (1992-1988). In: Source book of health insurance data. Washington, D.C.: Health Insurance Association of America, 1990:86.
12. Department of Health and Human Services, Health Care Financing Administration. Medicare program: physician performance standard rate of increase for federal fiscal year 1990. Fed Regist 1989; 54:53818-53821
13. Miller ME, Welch WP Physician charges in the hospital: exploring episodes of care for controlling volume growth. Med Care 1992; 30:630-645
14. Pope GC, Hurdle S, Posner JG, Henderson M. An index of Medicare prevailing charges: report to the Health Care Financing Administration. Needham, Mass.: Center for Health Economics Research, 1988.
15. Lazenby HC, Letsch SW National health expenditures, 1989. Health Care Financ Rev 1990; 12:1-26
16. Connell FA, Blide LA, Hanken MA Clinical correlates of small area variations in population-based admission rates for diabetes. Med Care 1984; 22:939-949
17. Roos NP, Roos LL Jr Surgical rate variations: do they reflect the health or socioeconomic characteristics of the population? Med Care 1982; 20:945-958
18. Wennberg JE, Fowler FJ Jr A test of the consumer contribution to small area variations in health care delivery. J Maine Med Assoc 1977; 68:275-279
19. Wennberg JE Population illness rates do not explain population hospitalization rates: a comment on Mark Blumberg's thesis that morbidity adjusters are needed to interpret small area variations. Med Care 1987; 25:354-359
20. Wennberg JE Which rate is right? N Engl J Med 1986; 314:310-311
21. Welch WP Prospective payment to medical staffs: a proposal. Health Aff (Millwood) 1989; 8:34-49
22. Fisher ES, Welch HG, Wennberg JE Prioritizing Oregon's hospital resources: an example based on variations in discretionary medical utilization. JAMA 1992; 267:1925-1931
23. Rice T, Bernstein J Volume performance standards: can they control growth in Medicare services? Milbank Q 1990; 68:295-319