Variations in the Use of Medical and Surgical Services by the Medicare Population

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Abstract
We measured geographic differences in the use of medical and surgical services during 1981 by Medicare beneficiaries (age ≥65) in 13 large areas of the United States. The average number of Medicare beneficiaries per site was 340,000. We found large and significant differences in the use of services provided by all medical and surgical specialties. Of 123 procedures studied, 67 showed at least threefold differences between sites with the highest and lowest rates of use. Use rates were not consistently high in one site, but rates for procedures used to diagnose and treat a specific disease varied together, as did alternative treatments for the same condition.