Practice variations: a challenge for physicians.
Practice variations: a challenge for physicians.
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实践变化：对医生的挑战。
DOI：
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发表时间：
1987
期刊：
影响因子：
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通讯作者：
J. H. Dawson
中科院分区：
文献类型：
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作者：
J. H. Dawson
医疗和外科手术的利用率在大区域和小区域都存在差异。在这一期的《华尔街日报》中，一系列的研究1-3检验了一个假设，即不恰当的使用水平可以解释地理差异。特别是，他们测试了一个假设，即表现出相对较高的利用水平的地区也经历了更高比例的不适当的照顾。在检查这一假设，冠状动脉造影术，颈动脉内膜切除术，上消化道内镜检查的应用的适当性进行了检查，并与1981年在13个治疗地点的利用率。该研究的结果并不“支持这样一种假设，即医疗和外科手术使用率高的地区主要或在任何有意义的程度上表现出这些高比率，因为这些地区的医生比使用率低的地区的医生更经常为不适当的适应症进行手术。"
Variation in the utilization rates of medical treatments and surgical procedures has been shown to occur across both large regions and small areas. In this issue ofTHE JOURNAL, a series of studies 1-3 examines the hypothesis that levels of inappropriate use explain geographic variations. In particular, they test the hypothesis that areas exhibiting relatively high levels of utilization also experience a higher percentage of inappropriate care. In examining this hypothesis, the appropriateness of the application of coronary angiography, carotid endarterectomy, and upper gastrointestinal tract endoscopy was examined and correlated with rates of utilization across 13 treatment sites in 1981. The findings of the study did not "support the hypothesis that areas with high use of medical and surgical procedures exhibit these high rates primarily or to any meaningful extent, because physicians in these areas perform procedures more often for inappropriate indications than their counterparts in areas of lower use."