The nature content and interpractice variation of general practice: a regional study in Italy.
The activity of 34 general practitioners (GP) working in solo practices in six Local Health Units were assessed, as a preliminary step of a main study, to evaluate and possibly improve the quality of GP professional performance using peer review and feed-back information. A wide interpractice variation was observed in patient visit and patient visiting rates, drug and test prescribing, in- and out-patient referrals, as well as in the composition of the practice case-mix. The extent of interpractice variation for relevant actions in the process of care was unchanged after adjusting for case-mix, suggesting that case-mix differences have little effect in explaining differences among physicians' overall pattern of care and health care resource consumptions.
Taroni
F
F
Laboratorio di Epidemiologia e Biostatistica, Istituto Superiore di Sanità, Roma, Italy.
Stiassi
R
R
Traversa
G
G
Raschetti
R
R
Menniti-Ippolito
F
F
Maggini
M
M
Spila-Alegiani
S
S
D000328:Adult; D000368:Aged; D003953:Diagnosis-Related Groups; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D010821:Physicians, Family / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011787:Quality of Health Care; D012017:Referral and Consultation