Regional Variations in Health Care Intensity and Physician Perceptions of Quality of Care

  1. Brenda E. Sirovich, MD, MS;
  2. Daniel J. Gottlieb, MS;
  3. H. Gilbert Welch, MD, MPH; and
  4. Elliott S. Fisher, MD, MPH
  1. From the Veterans Affairs Medical Center Outcomes Group, White River Junction, Vermont, and the Center for Evaluative Clinical Sciences at Dartmouth College, Hanover, New Hampshire.
    1. Figure 1. Crude and adjusted results are presented. The number of respondents, shown in parentheses, differs for each question because some questions did not apply to some specialties and because of some item nonresponse (<1% for each question). *Adjusted for all variables included in the final model (patient, physician, and practice characteristics; market-level managed care; local hospital bed and physician supply).
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      Figure 1. Crude and adjusted results are presented. The number of respondents, shown in parentheses, differs for each question because some questions did not apply to some specialties and because of some item nonresponse (<1% for each question). *Adjusted for all variables included in the final model (patient, physician, and practice characteristics; market-level managed care; local hospital bed and physician supply). Proportion of physicians practicing in regions with differing levels of local health care intensity who report being able to obtain the following services when medically necessary.
    2. Figure 2. Crude and adjusted results are presented. The number of respondents, shown in parentheses, differs for each question because some questions did not apply to some specialties and because of some item nonresponse (<1% for each question). *Adjusted for all variables included in the final model (patient, physician, and practice characteristics; market-level managed care; local hospital bed and physician supply). †Primary care physicians were asked about their communication with specialists and vice versa. ‡Response categories differed from those for the other 5 questions. These results reflect physicians who responded that they were “somewhat satisfied” or “very satisfied” with their overall career.
      View larger version:
      Figure 2. Crude and adjusted results are presented. The number of respondents, shown in parentheses, differs for each question because some questions did not apply to some specialties and because of some item nonresponse (<1% for each question). *Adjusted for all variables included in the final model (patient, physician, and practice characteristics; market-level managed care; local hospital bed and physician supply). †Primary care physicians were asked about their communication with specialists and vice versa. ‡Response categories differed from those for the other 5 questions. These results reflect physicians who responded that they were “somewhat satisfied” or “very satisfied” with their overall career. Proportion of physicians practicing in regions with differing levels of local health care intensity who agree with the following statements about their practice experience.

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