Geographic Variation of Endoscopic Sinus Surgery in Canada: An Alberta-Based Small Area Variation Analysis

Area of Science:

• Otolaryngology
• Health Services Research
• Surgical Outcomes

Background:

• Endoscopic sinus surgery (ESS) is a common procedure in Canada.
• Identifying unwarranted practice variations is crucial for healthcare quality.
• Geographic variations in surgical rates can impact patient outcomes and resource allocation.

Purpose of the Study:

• To examine the rates and geographic variation of ESS in Alberta, Canada.
• To identify potential unwarranted practice patterns in ESS delivery.

Main Methods:

• A small area variation analysis was conducted using data from Alberta, Canada.
• The National Ambulatory Care Reporting System database identified ESS cases between 2010 and 2013.
• Annual adjusted ESS rates per 1000 people were calculated and geographic variations were quantified.

Main Results:

• The annual adjusted ESS rate in Alberta was 0.33 per 1000 people.
• A 7-fold difference in ESS rates was observed between the highest and lowest regions.
• Analysis demonstrated "very high" geographic variation in ESS rates across Alberta.

Conclusions:

• Significant geographic variation in ESS rates exists within Alberta, Canada.
• This variation suggests potential unwarranted practice patterns.
• Further evaluation of ESS delivery is needed to enhance Canadian health system performance.