Unwarranted Variation
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Unwarranted Variation
Unwarranted variation (or geographic variation) in health care service delivery refers to medical practice pattern variation that cannot be explained by illness, medical need, or the dictates of evidence-based medicine. It is one of the causes of low value care often ignored by health systems. Definition Unwarranted variation (or geographic variation) in health care service delivery refers to differences that cannot be explained by personal preference, illness, medical need, or the dictates of evidence-based medicine. The term was coined by Dr. John Wennberg. Unwarranted variation reveals three areas: * Overuse of treatments (or overutilisation) such that more harm than good is being done *Underuse of treatments such that cost-effective interventions are not being provided *Inequity of care (a subset of underuse) such that parts of the population are not accessing treatment, possibly because of their social background. Supply-sensitive care, which is strongly correlated with heal ...
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John Wennberg
John E. "Jack" Wennberg (born June 2, 1934) is the pioneer and leading researcher of unwarranted variation in the healthcare industry. In four decades of work, Wennberg has documented the geographic variation in the healthcare that patients receive in the United States. In 1988, he founded the Center for the Evaluative Clinical Sciences at Dartmouth Medical School (now The Dartmouth Institute for Health Policy and Clinical Practice at Geisel School of Medicine at Dartmouth) to address that unwarranted variation in healthcare. He is the Peggy Y. Thomson Professor Emeritus in the Evaluative Clinical Sciences & Founder and Director Emeritus of The Dartmouth Institute for Health Policy & Clinical Practice (formerly the Center for the Evaluative Clinical Sciences), and has been Professor in the Department of Community and Family Medicine since 1980 and in the Department of Medicine since 1989. Wennberg is the founding editor of the Dartmouth Atlas of Health Care, a series of reports on ho ...
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Health Dialog
Health Dialog, part of the Rite Aid Corporation family of healthcare companies, provides personalized population health services to health plans, providers, employers and pharmaceutical manufacturers. The company helps their clients improve quality of care and reduce healthcare costs while empowering members to make informed health and wellness decisions. The company has been offering population health services since 1997. They offer multi-channel health coaching with registered nurses who are licensed to practice in all 50 states, D.C. and Guam and hold multiple accreditations and certifications from URAC, NCQA The National Committee for Quality Assurance (NCQA) is an independent 501(c)(3) nonprofit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and ... and HITRUST. Health Coaches and Care Navigators Health Dialog staffs their population health management programs with hi ...
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Chicago
(''City in a Garden''); I Will , image_map = , map_caption = Interactive Map of Chicago , coordinates = , coordinates_footnotes = , subdivision_type = Country , subdivision_name = United States , subdivision_type1 = State , subdivision_type2 = Counties , subdivision_name1 = Illinois , subdivision_name2 = Cook and DuPage , established_title = Settled , established_date = , established_title2 = Incorporated (city) , established_date2 = , founder = Jean Baptiste Point du Sable , government_type = Mayor–council , governing_body = Chicago City Council , leader_title = Mayor , leader_name = Lori Lightfoot ( D) , leader_title1 = City Clerk , leader_name1 = Anna Valencia ( D) , unit_pref = Imperial , area_footnotes = , area_tot ...
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Fort Lauderdale
A fortification is a military construction or building designed for the defense of territories in warfare, and is also used to establish rule in a region during peacetime. The term is derived from Latin ''fortis'' ("strong") and ''facere'' ("to make"). From very early history to modern times, defensive walls have often been necessary for cities to survive in an ever-changing world of invasion and conquest. Some settlements in the Indus Valley civilization were the first small cities to be fortified. In ancient Greece, large stone walls had been built in Mycenaean Greece, such as the ancient site of Mycenae (famous for the huge stone blocks of its 'cyclopean' walls). A Greek '' phrourion'' was a fortified collection of buildings used as a military garrison, and is the equivalent of the Roman castellum or English fortress. These constructions mainly served the purpose of a watch tower, to guard certain roads, passes, and borders. Though smaller than a real fortress, they acted ...
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Bloomington, Indiana
Bloomington is a city in and the county seat of Monroe County, Indiana, Monroe County in the central region of the U.S. state of Indiana. It is the List of municipalities in Indiana, seventh-largest city in Indiana and the fourth-largest outside the Indianapolis metropolitan area. According to the Monroe County History Center, Bloomington is known as the "Gateway to Scenic Southern Indiana". The city was established in 1818 by a group of settlers from Kentucky, Tennessee, the Carolinas, and Virginia who were so impressed with "a haven of blooms" that they called it Bloomington. The population was 79,168 at the 2020 United States census, 2020 census. Bloomington is the home to Indiana University Bloomington, the flagship campus of the Indiana University, IU System. Established in 1820, IU Bloomington has 45,328 students, as of September 2021, and is the original and largest campus of Indiana University. Most of the campus buildings are built of Indiana limestone. Bloomington has ...
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Albuquerque
Albuquerque ( ; ), ; kee, Arawageeki; tow, Vakêêke; zun, Alo:ke:k'ya; apj, Gołgéeki'yé. abbreviated ABQ, is the most populous city in the U.S. state of New Mexico. Its nicknames, The Duke City and Burque, both reference its founding in 1706 as ''La Villa de Alburquerque'' by Nuevo México governor Francisco Cuervo y Valdés''.'' Named in honor of the Viceroy of New Spain, the 10th Duke of Alburquerque, the city was an outpost on El Camino Real linking Mexico City to the northernmost territories of New Spain. Located in the Albuquerque Basin, the city is flanked by the Sandia Mountains to the east and the West Mesa to the west, with the Rio Grande and bosque flowing from north-to-south. According to the 2020 census, Albuquerque had 564,559 residents, making it the 32nd-most populous city in the United States and the fourth largest in the Southwest. It is the principal city of the Albuquerque metropolitan area, which had 916,528 residents as of July 2020, an ...
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Miami
Miami ( ), officially the City of Miami, known as "the 305", "The Magic City", and "Gateway to the Americas", is a East Coast of the United States, coastal metropolis and the County seat, county seat of Miami-Dade County, Florida, Miami-Dade County in South Florida, United States. With a population of 442,241 at the 2020 United States census, 2020 census, it is the List of municipalities in Florida, second-most populous city in Florida and the eleventh-most populous city in the Southeastern United States. The Miami metropolitan area is the ninth largest in the U.S. with a population of 6.138 million in 2020. The city has the List of tallest buildings in the United States#Cities with the most skyscrapers, third-largest skyline in the U.S. with over List of tallest buildings in Miami, 300 high-rises, 58 of which exceed . Miami is a major center and leader in finance, commerce, culture, arts, and international trade. Miami's metropolitan area is by far the largest urban econ ...
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Minneapolis
Minneapolis () is the largest city in Minnesota, United States, and the county seat of Hennepin County. The city is abundant in water, with thirteen lakes, wetlands, the Mississippi River, creeks and waterfalls. Minneapolis has its origins in timber and as the flour milling capital of the world. It occupies both banks of the Mississippi River and adjoins Saint Paul, the state capital of Minnesota. Prior to European settlement, the site of Minneapolis was inhabited by Dakota people. The settlement was founded along Saint Anthony Falls on a section of land north of Fort Snelling; its growth is attributed to its proximity to the fort and the falls providing power for industrial activity. , the city has an estimated 425,336 inhabitants. It is the most populous city in the state and the 46th-most-populous city in the United States. Minneapolis, Saint Paul and the surrounding area are collectively known as the Twin Cities. Minneapolis has one of the most extensive public par ...
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Primary Care Trust
Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May 2011, they also provided community health services directly. Collectively PCTs were responsible for spending around 80 per cent of the total NHS budget. Primary care trusts were abolished on 31 March 2013 as part of the Health and Social Care Act 2012, with their work taken over by clinical commissioning groups. Establishment In 1997 the incoming Labour Government abolished GP Fundholding. In April 1999 they established 481 primary care groups in England "thereby universalising fundholding while repudiating the concept." Primary and community health services were brought together in a single Primary Care Group controlling a unified budget for delivering health care to and improving the health of communities of about 100,000 people. A PC ...
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Overutilization
Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012. Factors that drive overuse include paying health professionals more to do more (fee-for-service), defensive medicine to protect against litigiousness, and insulation from price sensitivity in instances where the consumer is not the payer—the patient receives goods and services but insurance pays for them (whether public insurance, private, or both). Such factors leave many actors in the system (doctors, patients, pharmaceutical companies, device manufacturers) with inadequate incentive to restrain health care prices or overuse. This drives payers, such as national health insurance systems or the U.S. ...
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Geodemography
Geodemography is the study of people based on where they live.; it links the sciences of demography, the study of human population dynamics, and geography, the study of the locational and spatial variation of both physical and human phenomena on Earth, along with sociology. It includes the application of geodemographic classifications for business, social research and public policy but has a parallel history in academic research seeking to understand the processes by which settlements (notably, cities) evolve and neighborhoods are formed. Geodemographic systems estimate the most probable characteristics of people based on the pooled profile of all people living in a small area near a particular address. Origins The origins of geodemographics are often identified as Charles Booth and his studies of deprivation and poverty in early twentieth century London, and the Chicago School of sociology. Booth developed the idea of 'classifying neighborhoods', exemplified by his multivariate c ...
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Medical Sociology
Medical sociology is the sociological analysis of medical organizations and institutions; the production of knowledge and selection of methods, the actions and interactions of healthcare professionals, and the social or cultural (rather than clinical or bodily) effects of medical practice. The field commonly interacts with the sociology of knowledge, science and technology studies, and social epistemology. Medical sociologists are also interested in the qualitative experiences of patients, often working at the boundaries of public health, social work, demography and gerontology to explore phenomena at the intersection of the social and clinical sciences. Health disparities commonly relate to typical categories such as class and race. Objective sociological research findings quickly become a normative and political issue. Early work in medical sociology was conducted by Lawrence J Henderson whose theoretical interests in the work of Vilfredo Pareto inspired Talcott Parsons inter ...
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