Keller R B, Soule D N, Wennberg J E, Hanley D F
Maine Medical Assessment Foundation, Manchester.
J Bone Joint Surg Am. 1990 Oct;72(9):1286-93.
Orthopaedists and other physicians in Maine organized the Maine Medical Assessment Foundation to deal with the problem of variations in the rates of hospitalization for orthopaedic conditions. Five musculoskeletal injuries and five orthopaedic procedures were selected for study. The variation in decision-making by orthopaedists was least for fractures of the ankle and fractures of the hip and was greatest for fractures of the forearm, derangement of the knee, and lumbosacral sprain. The rates in an area tended to be consistently high or low for the same treatments. The major reasons for the variations appeared to be related to lack of agreement about optimum treatment. Feedback of data to physicians on variations in patterns of practice reduced the variations.
缅因州的骨科医生和其他医生组建了缅因州医学评估基金会，以应对骨科疾病住院率存在差异的问题。研究选取了五种肌肉骨骼损伤和五种骨科手术。骨科医生在决策上的差异，对于脚踝骨折和髋部骨折来说最小，而对于前臂骨折、膝关节紊乱和腰骶部扭伤来说最大。同一地区相同治疗的住院率往往持续偏高或偏低。出现差异的主要原因似乎与对最佳治疗方案缺乏共识有关。向医生反馈有关医疗模式差异的数据后，差异有所减少。
