Geographic variation of endoscopic sinus surgery in the united states

摘要: Objectives/Hypothesis The objective of this study was to examine the rates and geographic variation endoscopic sinus surgery (ESS) in a representative sample US working population. Study Design Observational cohort using MarketScan Commercial Claim Encounters database. Methods All patients who received ESS between 2009 2013 were included. The annual adjusted per 1,000 people calculated for each state. Geographic variations evaluated extremal quotient (EQ), weighted coefficient (CV), systematic component variance (SCV), empirical Bayes statistic. χ2 statistic tests used quantify across states within US. Results The rate 0.94 US. South Dakota Alabama observed have highest ESS, 1.80 1.69, respectively. Vermont Arkansas lowest 0.51 0.57, mean EQ 4.54, indicating four- fivefold difference (South Dakota) (Vermont) states. CV 31.4 SCV 10.1, which demonstrates very high variation. Conclusions This United States. Given that practice indicates presence potentially harmful inefficient unwarranted care, outcomes from indicate need further evaluate delivery improve overall health system performance. Level Evidence 2b. Laryngoscope, 125:1772–1778, 2015