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Practice variation in Swedish primary care

S Peterson1, M Eriksson, G Tibblin

  • 1Department of Family Medicine, Uppsala University, Sweden.

Scandinavian Journal of Primary Health Care
|June 1, 1997
PubMed
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Physician practice patterns for common ailments vary significantly, leading to six-fold cost differences in diagnostic tests, drugs, and sick leave. This highlights variations in primary health care resource utilization.

Area of Science:

  • Health Services Research
  • Primary Health Care
  • Health Economics

Background:

  • Physician practice patterns significantly influence healthcare resource consumption.
  • Variations in diagnostic testing, medication prescription, and sick leave policies impact overall healthcare costs.
  • Understanding these practice variations is crucial for optimizing healthcare delivery and social security systems.

Purpose of the Study:

  • To analyze individual physician practice patterns in primary health care using standardized simulated cases.
  • To correlate these practice patterns with resource consumption, including diagnostic tests, medications, and sick leave.
  • To evaluate resource utilization from the combined perspectives of healthcare and social security systems.

Main Methods:

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  • A postal questionnaire was used, presenting six hypothetical cases of common primary care ailments.
  • Physicians were asked to detail their planned diagnostic tests, procedures, drug prescriptions, follow-up appointments, and sick pay.
  • The study included 200 randomly selected physicians from Swedish primary health care centers.

    • Main Results:

    • Significant variation in physician practice patterns was observed, resulting in a six-fold difference in total costs between physicians.
    • Prescribed sick leave, representing lost productivity, constituted the largest cost component.
    • Physicians practicing further from hospitals and those with more years of experience tended to prescribe more interventions, though this explained only a small part of the variation.

    Conclusions:

    • Simulated common medical ailments revealed substantial differences in primary care physician practice styles.
    • These practice style variations led to significant, up to six-fold, differences in the costs of measures prescribed during initial patient visits.
    • The findings underscore the need to address practice variations to improve efficiency and cost-effectiveness in primary health care.