Variations in physicians' hospitalization practices: a population-based study in Manitoba, Canada.

Abstract:

:This paper uses claims data from a universal health care system to describe physicians' hospitalization styles after adjusting for case-mix characteristics of their primary patients. Patients were uniquely assigned to that physician (general or family practitioners, internist, general surgeon, or obstetrician/gynecologist) seen most frequently over each two two-year periods (1972-74 and 1974-76). Four indices were developed including: 1) percentage of primary patients hospitalized; 2) mean number of readmissions for such patients; 3) mean length of stay; and 4) total days of hospitalization per primary care patient (a summary measure combining the first three). Rates of admission, not length of stay, were shown to be strongly related to this summary measure. Marked variations in the hospitalization indices were observed across physicians; these variations cannot be explained by the health or sociodemographic characteristics of a physician's patients. Rural physicians practicing in areas with high bed-to-population ratios and low occupancy rates were particularly high users of hospitals. The economic implications of different practice styles are shown to be large; physicians who were high users of hospitals serve 27 per cent of the patients but their patients consume 42 per cent of the hospital days.

journal_name

Am J Public Health

authors

Roos NP,Flowerdew G,Wajda A,Tate RB

doi

10.2105/ajph.76.1.45

subject

Has Abstract

pub_date

1986-01-01 00:00:00

pages

45-51

issue

1

eissn

0090-0036

issn

1541-0048

journal_volume

76

pub_type

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