on Facebook
on Twitter
on YouTube
Document Information
Variations in the Use of Medical and Surgical Services by the Medicare Population
This Note is reprinted from the New England Journal of Medicine, v. 314, January 30, 1986. The authors measured geographic differences in the use of medical and surgical services during 1981 by Medicare beneficiaries (age 65 or over) in 13 large areas of the United States. The average number of Medicare beneficiaries per site was 340,000. They found large and significant differences in the use of services provided by all medical and surgical specialties. Of 123 procedures studied, 67 showed at least threefold differences between sites with the highest and lowest rates of use. Use rates were not consistently high in one site, but rates for procedures used to diagnose and treat a specific disease varied together, as did alternative treatments for the same condition. These results cannot be explained by the actions of a small number of physicians. It is not clear whether physicians in high-use areas performed too many procedures, whether physicians in low-use areas performed too few, or whether neither or both of these explanations is accurate. The differences are too large to ignore, however, and unless they are understood at a clinical level, uninformed policy decisions that have adverse effects on the health of the elderly may be made.
Support RAND Research — Buy This Product!
Paperback Cover Price: $20.00
Discounted Web Price: $18.00
Pages: 6
Free, downloadable PDF file(s) are available below.
RAND makes an electronic version of this document available for free as a public service. If you find this information valuable, please consider purchasing a paper copy of the full document to help support RAND research.
Use Adobe Acrobat Reader version 7.0 or higher for the best experience.
This product is part of the RAND Corporation note series. The note was a product of the RAND Corporation from 1979 to 1993 that reported other outputs of sponsored research for general distribution.
Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.
The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.
Top
RAND® is a registered trademark. Copyright © 1994-2009 RAND Corporation. Last Modified: April 27, 2009 