Do Patient, Physician, and Hospital Characteristics Affect Appropriateness and Outcome of Selected Procedures?

by Robert H. Brook, Rolla Edward Park, Mark R. Chassin, Jacqueline Kosecoff, Joan Keesey, David Solomon

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This report contains two separate but related reports. Both use data from the RAND/UCLA Health Services Utilization Study (HSUS) supplemented by additional data on patient, physician, and hospital characteristics. One relates these additional data to the appropriateness with which the three HSUS procedures (coronary angiography, upper gastrointestinal endoscopy, and carotid endarterectomy) were performed. The other relates the additional data to the incidence of adverse outcomes for one of the procedures (carotid endarterectomy). These papers are reprinted from the New England Journal of Medicine and the Annals of Internal Medicine, together with additional appendix material explaining methods in more detail and presenting alternative estimates by way of sensitivity analysis.

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