title: Variation in surgical rates: a population study.
abstract: OBJECTIVE
  The objective of this study was to compare the use of certain surgical services by physicians to three other professional groups (architects, lawyers, and nurses) and to the general population. To meet this objective, variations in six surgical procedures were studied: appendectomy, tonsillectomy, herniorrhaphy, cholecystectomy, cesarean section, and hysterectomy.
  
  
  METHODS
  This was a cross-sectional study in the city of Valencia (Spain) from September 1992 to September 1993. The surveys were carried out by mail questionnaire. Two thousand ninety-six subjects were recruited by simple random sampling for each of the groups. The questionnaire contained questions referring to the interviewee and to each family member (spouse or partner and up to a maximum of four children). The proportion of subjects who stated that they had undergone a particular type of surgery was compared among the professional groups. The population denominator was the whole Valencia population.
  
  
  RESULTS
  The global response rate was 83.7%. With the exception of herniorrhaphy, the rates of surgical procedures obtained for each procedure for the different groups were not significantly different. The frequency of operations for each group differed according to sex and age. The risk of undergoing tonsillectomy was significantly higher among the general population when there were no medical friends or relatives than when there were.
  
  
  CONCLUSIONS
  Barriers against access to surgical care did not seem to have played an important role in the use of surgical services. The frequency of operations for the best informed consumers with the most access to these services, that is, physicians, was very similar to that for other population groups.
authors.affiliation: Instituto Valenciano de Estudios en Salud Pública (IVESP), Valencia, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Ruiz
authors.forename: I
authors.initials: I
authors.lastname: Hernandez-Aguado
authors.forename: P
authors.initials: P
authors.lastname: Garrido
mesh_terms: D000293:Adolescent; D000328:Adult; D001108:Architecture / Q000706:statistics & numerical data; D002648:Child; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007603:Jurisprudence; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000706:statistics & numerical data; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D013030:Spain / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D014600:Utilization Review