Which Rate Is Right?

The amount of medical care people receive varies substantially, depending on the local hospital market area1 2 3 4 5 and the region6 or the country where they live. In this issue, Chassin and his colleagues6 show large variations in the rates of most diagnostic and surgical procedures among Medicare populations living in 13 large regions of the United States. Although a few operations, such as inguinal hernia repair, showed relatively little variation, more than half, including such invasive procedures as coronary bypass surgery, showed more than a threefold variation between regions. The authors are not able to interpret the clinical implications of the . . .