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Variations in Healthcare Spending and Quality Among Institutions

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Medical Practice Variations

Part of the book series: Health Services Research ((HEALTHSR))

Abstract

Unwarranted institutional variations in healthcare spending and quality may indicate discrepancies in the quantity of services provided, management efficiency, and staff capability at the hospital level. Because not all variations are unwarranted, analyses must take into account differences in the needs and preferences of the patient groups served. Variations can be influenced by factors such as payment systems, hospital ownership, management methods, resource availability, teaching status, and practice patterns. Although institutional variations may be intertwined with variations at the regional level, some measures of care, such as nosocomial infection rates or indicators of hospital management efficiency, are more meaningful when quantified at the hospital level. The accurate identification of unwarranted variations that stem from causes at the institutional level would also help to identify the stakeholders and decision makers who have the relevant authority and jurisdiction to address the problems. In this chapter, the empirical evidence of institutional variations in healthcare spending, medical practice patterns, and outcomes are introduced. Common methodologies used for measuring variations and the possible determinants of these variations are addressed, and the methods to reduce unwarranted variations are examined.

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Authors and Affiliations

  1. Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, 606-8501, Kyoto, Sakyo-ku, Japan

    Tetsuya Otsubo, Yuichi Imanaka, Toshitaka Morishima, Noriko Sasaki, Sungchul Park & Jason Lee

Authors
  1. Tetsuya Otsubo
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  2. Yuichi Imanaka
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  3. Toshitaka Morishima
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  4. Noriko Sasaki
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  5. Sungchul Park
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  6. Jason Lee
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Correspondence to Tetsuya Otsubo .

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Editors and Affiliations

  1. Department of Public Health Sciences, Queen's University Centre for Health Services and Policy Re, Kingston, Canada

    Ana Johnson

  2. Institute for Clinical Evaluative Scienc, Toronto, Ontario, Canada

    Thérèse Stukel

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Otsubo, T., Imanaka, Y., Morishima, T., Sasaki, N., Park, S., Lee, J. (2015). Variations in Healthcare Spending and Quality Among Institutions. In: Johnson, A., Stukel, T. (eds) Medical Practice Variations. Health Services Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7573-7_89-3

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  • DOI: https://doi.org/10.1007/978-1-4899-7573-7_89-3

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