Geographic Variation in Rates of Selected Surgical Procedures Within Los Angeles County

Published In: Health Services Research, v. 30, no. 1, Part 1, Apr. 1995, p. 27-42

Posted on RAND.org on January 01, 1995

by David Carlisle, R. Burciaga Valdez, Martin F. Shapiro, Robert H. Brook

Read More

Access further information on this document at www.ncbi.nlm.nih.gov

This article was published outside of RAND. The full text of the article can be found at the link above.

Uses data from the California Discharge Dataset to examine geographic variation in the use of eight procedures among Los Angeles County residents. The study concludes that the use of some of these surgical procedures varies even in a single, large urban area, and that this variation is significantly associated with population ethnicity and socioeconomic status. The highest variations in the use of procedures were for coronary angioplasty and carotid endarterectomy, and the lowest were for cardiac pacemaker implantation and hysterectomy. Variation was significantly related to income and African American or Latino Zip Code for all procedures except cardiac pacemaker implantation. For all procedures except appendectomy, the direction of the effect was toward fewer procedures for those with lower incomes.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.