Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Explaining geographic variations. The enthusiasm hypothesis

M R Chassin1

  • 1New York State Health Department, Albany 12237.

Medical Care
|May 1, 1993
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Surfactant use for premature infants with respiratory distress syndrome in three New York city hospitals: discordance of practice from a community clinician consensus standard.

Journal of perinatology : official journal of the California Perinatal Association·2010
Same author

Has evidence changed practice?: appropriateness of carotid endarterectomy after the clinical trials.

Neurology·2007
Same author

Association of surgical specialty and processes of care with patient outcomes for carotid endarterectomy.

Stroke·2001
Same author

Improving quality, minimizing error: making it happen.

Health affairs (Project Hope)·2001
Same author

Improving the quality of health care: who will lead?

Health affairs (Project Hope)·2001
Same author

Windows of opportunity to improve diabetes care when patients with diabetes are hospitalized for other conditions.

Diabetes care·2001
Same journal

Hepatitis C Virus Cascade of Care in Florida Emergency Departments.

Medical care·2026
Same journal

Association of Neighborhood Socioeconomic Disadvantage and Uptake of Diabetes Prevention Interventions.

Medical care·2026
Same journal

Machine Learning for Evaluating the Heterogeneous Effects of Intensive In-Hospital Rehabilitation During the Postacute Phase After Hip Fracture Surgery on Activities of Daily Living.

Medical care·2026
Same journal

Hospital-Physician Integration and Differences in the Use of Orthopedic Care Across Race and Ethnicity.

Medical care·2026
Same journal

The Impact of an Oncology Hospital at Home Program on Health Care Costs.

Medical care·2026
Same journal

In the Shadows: Health Utilization Outcomes Among Black Undocumented Immigrants.

Medical care·2026
See all related articles

Geographic variations in healthcare use are not due to unnecessary care or uncertainty. Instead, physician enthusiasm for specific services significantly drives these healthcare utilization differences.

Area of Science:

  • Health Services Research
  • Medical Economics
  • Physician Behavior

Background:

  • Geographic variations in healthcare utilization remain a significant puzzle for researchers.
  • Previous hypotheses, including unnecessary care and clinical uncertainty, lack empirical support.
  • Understanding these variations is crucial for healthcare resource allocation and policy development.

Purpose of the Study:

  • To propose and evaluate the "enthusiasm hypothesis" as a novel explanation for geographic variations in healthcare service utilization.
  • To investigate the role of physician enthusiasm for specific procedures in driving regional differences in their use.
  • To test the enthusiasm hypothesis using data on carotid endarterectomy.

Main Methods:

  • Review and synthesis of existing literature on geographic variations in healthcare use.

Related Experiment Videos

  • Analysis of previously published data on carotid endarterectomy rates across different geographic areas.
  • Application of the "enthusiasm hypothesis" framework to interpret observed utilization patterns.

    • Main Results:

    • Evidence does not support the hypothesis that higher utilization is driven by unnecessary care.
    • Data also do not support the contention that clinical uncertainty is the primary driver of variations.
    • Analysis suggests that the prevalence of physicians enthusiastic about particular services correlates with geographic utilization rates.

    Conclusions:

    • The "enthusiasm hypothesis" offers a compelling explanation for geographic variations in healthcare services.
    • Physician enthusiasm for specific interventions appears to be a key factor influencing regional healthcare utilization.
    • Further research is warranted to explore the implications of physician enthusiasm in other medical fields and procedures.