Relation Between Pediatric Experience and Treatment Recommendations for Children and Adolescents With Kidney Failure

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Abstract
Marked variations in the utilization of selected health care services and subsequent health care costs exist in the United States.1,2 Even after taking into account the underlying health and diagnosis of the patient, variations in the use of selected services, particularly those whose benefits are less well established, cannot be explained fully. Variations in referral rates to subspecialists,3 treatment recommendations by internists, family physicians, gynecologists, surgeons, and psychiatrists,4,5 and use of invasive procedures6 have been described repeatedly in the care of adult patients. The extent to which variation exists in the care of children with chronic illness, and examination of the potential sources of this variation have been studied infrequently.7