Stano M
Inquiry. 1986 Summer;23(2):176-82.
To examine Wennberg's "variations in practice style" hypothesis, I examined a comprehensive data base that reflected the use of physician services in Michigan. In addition to wide variations in per capita rates of utilization across physician services markets, I found wide variations within markets in the intensity with which physicians treat their patients. I also found that within high-use markets, physicians don't treat their patients more intensively than do physicians in other markets; rather, patients are treated by a larger number of providers. Significantly, there was no relationship between variations in practice intensity within markets and per capita levels of use. I discuss the relevance of my findings for Wennberg's proposals to reduce utilization and for other health care policy issues.
为了检验温伯格的“医疗实践风格差异”假说，我研究了一个反映密歇根州医生服务使用情况的综合数据库。除了各医生服务市场人均利用率存在巨大差异外，我还发现市场内部医生治疗患者的强度也存在很大差异。我还发现，在高使用量市场中，医生治疗患者的强度并不比其他市场的医生更高；相反，是有更多的医疗服务提供者为患者提供治疗。值得注意的是，市场内部实践强度的差异与人均使用水平之间没有关系。我讨论了我的研究结果对于温伯格关于降低利用率的提议以及其他医疗保健政策问题的相关性。
