Future Directions for Small Area Variations

A description of the health care delivery system, i.e., the types and quantities of resources deployed, such as the numbers of hospital beds and physicians per capita and the per capita expenditures for care, and the services produced, in the aggregate and specifically.

Abstract

From the Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire. Address correspondence to: John E. Wennberg, MD, Dartmouth Medical School, Center for the Evaluative Clinical Sciences, Strasenburgh Hall, Room 332, Hanover, NH 03755-3863. sive description of the health care delivery system, i.e., the types and quantities of resources deployed, such as the numbers of hospital beds and physicians per capita; the per capita expenditures for care; the services produced, in the aggregate and specifically (such as the rates for specific procedures); and the health care outcomes that occur at the population level. Fourth, it seeks answers to policy-relevant questions. When variations occur, why do they occur? What is the role of consumers (patients)? What are the roles of suppliers and public policy? How does variability relate to productivity? When greater amounts of resources are deployed (such as hospital beds or neurosurgeons per capita), what additional services are provided? When more is provided, what are the consequences for health outcomes?