This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

J. Leighton Read, MD; Robert S. Stern, MD; L. A. Thibodeau, PhD; Daniel E. Geer, Jr, SB; Henry Klapholz, MEE, MD

JAMA. 1983;249(12):1605-1609.

Abstract
Variation in the use of diagnostic procedures may be due to characteristics of patients, physicians, or their environment. Testing rates for 24-hour urinary estriol levels (EST), diagnostic ultrasound, and antepartum fetal heart rate testing (AFHRT) were examined in 8,527 deliveries from 1975 through 1978. Over the period, utilization of EST remained constant at about 7% of deliveries, while ultrasound increased from 20% to 35% and AFHRT, from 7% to 12%. This increase persisted after stratifying patients on a multivariate confounder score using 45 items of clinical information. Those receiving antenatal care in a hospital-based group practice or a resident-staffed community clinic were more likely to be tested than patients seen in private offices or a prepaid group practice.

(JAMA 1983;249:1605-1609)

Author Affiliations
From the West Roxbury (Mass) Veterans Administration Medical Center (Dr Read); Departments of Medicine (Dr Stern and Mr Geer) and Obstetrics and Gynecology (Dr Klapholz) and the Charles Dana Research Foundation, Beth Israel Hospital, Boston; and Center for the Analysis of Health Practices (Drs Read, Stern, and Thibodeau, and Mr Geer), Harvard School of Public Health, Boston; and Applied Management Sciences, Silver Spring, Md (Dr Thibodeau).

Footnotes
Reprint requests to Center for the Analysis of Health Practices, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115 (Dr Read).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Quality Measures for Prenatal Care: A Comparison of Care in Six Health Care Plans
Murata et al.
Arch Fam Med 1994;3:41-49.
ABSTRACT  

Practice Variation: Learned and Socio-Economic Factors
Maryniuk
ADR 1990;4:19-24.
ABSTRACT  

How Will Changes in Physician Payment by Medicare Influence Laboratory Testing?
JAMA 1987;258:803-808.
ABSTRACT  

Physician Characteristics and Organizational Factors Influencing Use of Ambulatory Tests
Epstein and McNeil
Med Decis Making 1985;5:401-415.
 

Use of Diagnostic Resources in Health Maintenance Organizations and Fee-for-Service Practice Settings
Dorsey
Arch Intern Med 1983;143:1863-1865.
ABSTRACT