Dartmouth Atlas Results for UK
Take a look at Britain’s effort to anglicize the Dartmouth work: Doctors in some areas such as the college town of Oxford do one type of hip replacement at rates up to 16 times greater than in places like London, according to a November atlas by the National Health Service…
The British atlas is surprising because “doctors are not by and large paid on a fee for service basis in the NHS,” [said] Angela Coulter, director of global initiatives for the Dartmouth Atlas-associated Foundation for Informed Medical Decision-Making…
Variations in the way doctors treat patients are “independent of the way health care’s organized and financed,” Dr. Jack Wennberg, the godfather of Dartmouth’s variation research.
Full article on the British atlas.
This is a very important finding. It shows that wide variations in clinical practice are not the result of fee-for-service medicine, as is so often claimed, but the result of bureaucratic medicine, in which normal market forces have been systematically suppressed.
This study may be new, but the finding is not new. There has been evidence for a long time (collected by RAND, I think) that there are wide variations in medical practice patterns in other countries and that these variations are as bad or worse than in the United states.
This result is consistent with previous studies and it is good for people to be aware of it. Maybe we will have a little less bashing of American health care.
In the United States fee-for-service payments are prevalent and there are regional variations in medical practice. If anything, I would expect fee-for-service to result in less regional variation. If doctors and hospitals hear that providers in one region are able to perform more procedures and get paid for them, why wouldn’t other providers copy the high-cost regions? I would be surprised if Britain didn’t have wide variations in medical practice from one health authority to another. We know the utilization of costly drugs varies from one health authority to another.
The article seems to say the inconsistencies are due to consumer preferences. If that’s true, is it really a problem if different consumers in different cities prefer different medical procedures?
Not a huge shock, but still nice to know that variation in the US is not because half of our doctors are greedy jerks.