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

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.