Geographic Variation in Quality of Care for Commercially Insured Patients. (3rd May 2016)

• Record Type: Journal Article
• Authors: McKellar, Michael Richard; Landrum, Mary Beth; Gibson, Teresa B.; Landon, Bruce E.; Fendrick, A. Mark; Chernew, Michael E.
• Is Part Of: Health services research. Volume 52:Number 2(2017)
• Page Start: 849
• Page End: 862
• Publication Date: 2016-05-03
• Subjects: Geographic variation -- quality -- spending -- markets; Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.12501
• Languages: English
• ISSNs: 0017-9124

Abstract

Abstract : Background: Extensive evidence documents geographic variation in spending, but limited research assesses geographic variation in quality, particularly among commercially insured enrollees. Objective: To measure geographic variation in quality measures, correlation among measures, and correlation between measures and spending for commercially insured enrollees. Data Source: Administrative claims from the 2007–2009 Truven MarketScan database. Methods: We calculated variation in, and correlations among, 10 quality measures across 306 Hospital Referral Regions (HRRs), adjusting for beneficiary traits and sample size differences. Further, we created a quality index and correlated it with spending. Results: The coefficient of variation of HRR‐level performance ranged from 0.04 to 0.38. Correlations among quality measures generally ranged from 0.2 to 0.5. Quality was modestly positively related to spending. Conclusion: Quality varied across HRRs and there was only a modest geographic "quality footprint."