Small area analysis: methodology and application.

The data derived from small area analysis type studies carried out in Iowa, Maine and other states is the focus of wide attention from many of the health care delivery system constituencies. These studies look at local patterns of practice. Results of such studies dramatically highlight the wide variances in rates of hysterectomies, prostatectomies or admissions for pulmonary disease between one population area and the next. These variances lead to some provocative discussions of their causes and relationships. Much has already been debated in the health care forum about the meanings of the data, and much more commentary can be expected as consumer groups, UR/QA professionals, those paying health care costs and the federal government join the discussions. In hopes of offering insight into small area analysis, JAMRA presents the following article.