While variations in quality of care have been described between US regions, physician-level practice pattern variations within regions remain poorly understood, notably among specialists. A study of 5 US metropolitan areas, published in JAMA Health forum, found sizeable physician-level practice variations across common clinical scenarios and specialties.
The study used 2016 through 2019 data from a large nationwide network of commercial insurers, provided by Health Intelligence Company, LLC, within 5 metropolitan statistical areas (MSAs). Physician-level variations in appropriateness and quality of care were measured using 14 common clinical scenarios involving 7 specialties. The measures were constructed using public quality measure definitions, clinical guidelines, and appropriateness criteria from the clinical literature. Physician performance was calculated using a multilevel model adjusted for patient age, sex, risk score, and socioeconomic status with physician random effects. A total of 8788 physicians were included across the 5 MSAs, and about 2.5 million unique patient-physician pairs were included in the measures. Data were analyzed March through October 2021.
The study concluded understanding the sources of these physician-level practice variations may inform efforts to improve the value of care.
Read more:
- Physician Practice Pattern Variations in Common Clinical Scenarios Within 5 US Metropolitan Areas. JAMA Health Forum. January 28 2022.