For Medicare patients, the decision to undergo elective surgery depends on where they live and the clinicians they see, according to a report from the Dartmouth Atlas Project and the Foundation for Informed Medical Decision Making.
For the study, researchers examined the rates of various elective procedures on Medicare patients, including mastectomy for breast cancer; coronary artery bypass surgery; back surgery; knee and hip joint replacement; carotid artery surgery; radical prostatectomy for prostate cancer; and prostate cancer screening.
- Wide regional variation was found in elective surgery rates for patients with similar conditions
- Men over 65 with early-stage prostate cancer who live in San Luis Obispo, CA were 12 times more likely to have surgery to remove their prostate than those in Albany, GA.
- Medicare patients with heart disease in Elyria, Ohio, were 10 times more likely to have a procedure such as angioplasty or stents than those in Honolulu.
- Women over 65 living in Victoria, Texas were seven times more likely to undergo mastectomy for early-stage breast cancer than women in Muncie, IN.
The researchers conclude that differences in clinicians’ personal beliefs and opinions, as well as lack of patient education and involvement in decision making contribute to the variation.
(Sources: Kaiser Daily Health Policy Project, http://kaiserhealthnews.org, February 24, 2011; Reuters, http://www.reuters.com, February 24, 2011; The Dartmouth Atlas, http://www.dartmouthatlas.org, February 24, 2011)