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Published on: February 16, 2011
Geographic Variation in Quality of Care for Commercially Insured Patients
Michael Richard McKellar1, Mary Beth Landrum2, Teresa B Gibson2
1Department of Health Care Policy, Harvard Medical School, Redondo Beach, CA.
Background:
Extensive evidence documents geographic variation in spending, but limited research assesses geographic variation in quality, particularly among commercially insured enrollees.
Objective:
To measure geographic variation in quality measures, correlation among measures, and correlation between measures and spending for commercially insured enrollees.
Data Source:
Administrative claims from the 2007-2009 Truven MarketScan database.
Methods:
We calculated variation in, and correlations among, 10 quality measures across 306 Hospital Referral Regions (HRRs), adjusting for beneficiary traits and sample size differences. Further, we created a quality index and correlated it with spending.
Results:
The coefficient of variation of HRR-level performance ranged from 0.04 to 0.38. Correlations among quality measures generally ranged from 0.2 to 0.5. Quality was modestly positively related to spending.
Conclusion:
Quality varied across HRRs and there was only a modest geographic "quality footprint."
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