Health services researchers have long been aware of large variations in the use of medical care among communities and regions. Insights into the geographic variation phenomenon, as presented in maps and other graphic displays, demonstrate once again that in health care markets, geography is destiny: the care one receives depends in large part on the supply of resources available in the place where one lives – and on the practice patterns of local physicians.
The existence of variation raises a number of important issues. Foremost is the question, “Which rate is right?” Which pattern of resource allocation, and which pattern of utilization, is “correct?” The study of practice variations reveals how complex this question really is. In the case of variations in rates of individual procedures, such as tonsillectomy and hysterectomy, the explanation is not that patients in areas with low procedure rates are going without treatment; they are, instead, being treated differently, often with more conservative medical management. Learning which rate is right requires learning what informed patients want. The right rate must be the one that reflects the choices of patients who have been adequately informed and empowered to choose among the available options.
This blog emphasizes using graphic displays of quantitative data to explore and better understand the geography of health and health care in the United States.
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