The credibility and ultimate success of programs that address variations in practice patterns and the utilization of health care are entirely dependent on a continuing source of reliable data. In existing programs that monitor geographic variations in health care utilization, physician response has been most favorable when the data allow comparison of populations and treatment modalities most similar to their own practice experience. Data that will identify not only current practice patterns, but also trends over time, are critical to the success of such programs; noteworthy examples are the Maine Medical Assessment Project and a similar program in Iowa sponsored by the Iowa State Medical Society in concert with the state hospital association.
Wennberg et al,1 in this issue of The Journal, have alerted us to such a continuing source of data derived from Medicare fiscal intermediaries, and possibly available from other commercial carriers. These data are population based,
McAfee RE. The Hospital 'Surgical Signature': A Quality-Assessment Tool. JAMA. 1987;257(7):972. doi:10.1001/jama.1987.03390070092031
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