Barnes B A, O'Brien E, Comstock C, D'Arpa D G, Donahue C L
JAMA. 1985 Jul 19;254(3):371-5.
This article presents an analysis of over 140,000 selected surgical procedures performed in Massachusetts in 1980, giving the per capita rates of 14 common procedures and of four less frequently performed procedures. The analysis defines 172 geographic areas for the commonly performed procedures and 45 for the less frequently performed procedures. Per capita surgical rates among the defined areas are significantly different from both a statistical and a clinical point of view. Twofold and threefold variations occur frequently across geographic areas. In certain areas, some surgical services appear to be provided at rates substantially different from the statewide rate. We discuss the importance of these data for physicians as well as the implications for the distribution and quality of clinical care and for containment of medical care costs.
本文对1980年在马萨诸塞州进行的超过140,000例选定外科手术进行了分析，给出了14种常见手术以及4种较少进行的手术的人均发生率。该分析为常见手术定义了172个地理区域，为较少进行的手术定义了45个地理区域。从统计学和临床角度来看，所定义区域内的人均手术率存在显著差异。地理区域间经常出现两倍和三倍的差异。在某些地区，一些外科服务的提供率似乎与全州的比率有很大不同。我们讨论了这些数据对医生的重要性以及对临床护理的分布和质量以及医疗费用控制的影响。
