Bailit H L, Clive J
Med Care. 1981 Jan;19(1):30-46. doi: 10.1097/00005650-198101000-00005.
This study examines the amount and sources of variation in dental practice profiles. Three years of insurance claims data on 227 general dental practices were used to generate practice-specific utilization rates for 16 treatment service categories. The results indicated considerable heterogeneity among and within practices in the distribution of service utilization rates such that most distributions could not be described by conventional parametric probability models. Basic standardization methods were used to examine sources of variation among practices. Of the patient and insurance characteristics investigated, only patient age had a major effect on utilization rates. However, there was considerable stability in utilization rates within practices over four consecutive six-month time intervals. The implications of these findings for profile-based utilization review and quality-assurance systems are discussed.
本研究考察了牙科诊疗模式的差异量及来源。利用227家普通牙科诊所三年的保险理赔数据，生成了16种治疗服务类别的特定诊所利用率。结果表明，各诊所之间以及诊所内部的服务利用率分布存在显著异质性，以至于大多数分布无法用传统的参数概率模型来描述。采用基本标准化方法来考察诊所间差异的来源。在所调查的患者和保险特征中，只有患者年龄对利用率有重大影响。然而，在连续四个六个月的时间间隔内，各诊所的利用率相当稳定。讨论了这些发现对基于模式的利用率审查和质量保证系统的影响。
