Posting date: October 7, 2004

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Health Affairs, 10.1377/hlthaff.var.140
Copyright © 2004 by Project HOPE

Web Exclusives

Perspective: Practice Variations And Health Care Reform: Connecting The Dots

¹ John Wennberg directs the Center for the Evaluative Clinical Sciences at Dartmouth Medical School in Hanover, New Hampshire.

^*Corresponding author.

Abstract

Unwarranted variation is a ubiquitous feature of U.S. health care. Remedies for variations exist, and several are described in the current collection of Health Affairs papers. Several obstacles stand in the way of widespread adoption of these remedies: (1) a quality agenda that has yet to focus on improving the quality of patient decision making; (2) economic incentives that do not reward exemplary practice; and (3) the poor state of clinical science. Medicare reform legislation creates the opportunity for a demonstration project to redesign health care to address these barriers. We also must grapple with the cultural bias that more care is better and that physicians must know best.

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

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