Posting date: October 7, 2004

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Health Affairs, 10.1377/hlthaff.var.104
Copyright © 2004 by Project HOPE

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Perspective: More Variation In Use Of Care, More Flat-Of-The-Curve Medicine

¹ Victor R. Fuchs is the Henry J. Kaiser Jr. Professor Emeritus, Stanford University, and a research associate at the National Bureau of Economic Research in Stanford, California.

^*Corresponding author.

Abstract

Variation in use of health care is ubiquitous in the United States. It is attributable to exogenous differences in supply of medical resources; to identified and unidentified economic, social, and cultural factors; and to the idiosyncratic beliefs of physicians. It is perpetuated by the parochial character of much clinical practice. Patients in high-intensity areas do not appear to have better health outcomes: Much care is "flat of the curve." A more robust scientific foundation for clinical decisions could help to reduce variations, but major reform of health care financing is probably necessary to achieve substantial improvement in the organization and delivery of care.

Key Words: Health Reform, Hospitals, Medicare, Physicians, Quality Of Care, Variations

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