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05/14/2012 Poverty and Health: A Connection We Can't Ignore

04/30/2012 Cardiac Care - A Case Study in Practice Variation

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Viewing entries tagged with 'variation'

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Cardiac Care - A Case Study in Practice Variation

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on April 30, 2012

In 2010, when we published our study on healthcare variation in Michigan, we were able to show considerable geographic variation around the state of Michigan on a variety of procedures and services. We intentionally chose services where the research indicated either a tendency toward over-utilization (relative to evidence-based guidelines) or where the guidelines were unclear.

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Antibiotics: More Progress to Be Made

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on February 28, 2011

In 1995, the Centers for Disease Control (CDC) launched a major initiative to reduce the overuse of antibiotics. While many people think that taking an antibiotic for viral infections is either beneficial or benign, the CDC knew that the overuse of antibiotics was leading to a significant increase in infections that were drug resistant.

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A Michigan Look at Variation in Medical Care: Where you live often determines what you get

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on October 4, 2010

This week our Center is releasing a report on geographic variation in health care use in Michigan. Geographic variation in the use of health care services has been well described in the literature for more than 20 years now. Jack Wennberg pioneered this kind of systematic analysis at Dartmouth and has been reporting this data on an ongoing basis looking at the Medicare population. In 1997, Jack partnered with Blue Cross and Blue Shield of Michigan to do the same kind of analysis looking at a commercial, under 65 year old population. The report in Michigan got a lot of attention when it was released in 2000 – and sparked some interesting community dialogs including one in Grosse Pointe, Michigan about why their rates of use for ADHD drugs was so high (highest in the state).

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The Flap About the Dartmouth Atlas

Marianne Udow-Phillips

Posted by Marianne Udow-Phillips on June 28, 2010

Earlier in June, the New York Times ran an article by Adleson and Reed questioning the findings in the Dartmouth Atlas. Jack Wennberg and colleagues have been working in this field and documenting small area variation in health care since the 1970s. However, the work was not much recognized outside of academic and health care analytic circles until the start of the discussion on national health reform. In a very short period of time, the analysis went from being in the sole domain of providers and policy wonks (hmm, could that be me?) to being on the tip of the tongue of policy makers in Congress and the White House. Tracing the trajectory of this research from relative obscurity to the New York Times article provides an interesting insight into both the policy making process and the risks and opportunities inherent in trying to translate research into public policy.

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