Medical Practice Variation

• Spine Care

• Breast Cancer Care

• Primary Care

Across the United States, there are large and often puzzling variations in medical expenses, treatment patterns, and quality. Much of this geographic variation has proven to be unwarranted; that is, it cannot be adequately explained by differences in illness rates, patient preferences or the dictates of evidence-based medicine. The premise for the Foundation is rooted in the belief that medical decisions made by informed patients offer great potential to reduce this problem.

Unwarranted medical practice variation has been studied and documented by researchers at Dartmouth under the direction and leadership of John E. Wennberg, MD, MPH. Researchers involved with the Dartmouth Atlas Project have been providing continuous feedback of population-based information describing resource inputs, utilization and outcomes of care among the 3,436 hospital service areas and 306 hospital referral regions in the United States.

Using up to 12 years of Medicare data, the Dartmouth Atlas Project is an eye-opening study that seeks to accurately describe how medical resources are distributed and used in the United States. It not only demonstrates glaring variations in how health care is delivered across the nation. It also shows that patients in regions with greater levels of spending and greater use of physician visits and hospitalizations do not experience better health care outcomes or quality of care. And it has led to legislation promoting demonstration projects to deal with unwarranted variations among the Medicare population.

The Dartmouth Atlas is a rich source of information that can provide a basis for improving health systems in every region of the country. Go there now.