[John E. Wennberg, pioneer of regional health services research: what does he teach us in Germany?].
Using claims data, Wennberg demonstrated regional health-care variation that was not due to differentials in morbidity nor was it preference-based, but was partly supply-sensitive. The structure, processes, and outcomes of care are imperfectly coupled, and more services are not necessarily associated with better outcomes. Feeding data back to the responsible providers, restraining capacities, and fostering patient autonomy are seen as important in reducing unwarranted variation in health-care service delivery. In Germany, regional analyses of claims data and disease registries confirm the heterogeneity of processes and outcomes. A reduction in regional variation is in the interest of patient safety and likely to improve the effectiveness and efficiency of medical care. More health-care delivery science-both analytic and experimental-is needed.
Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland, bernt-peter.robra@med.ovgu.de.
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D003153:Community Health Services / Q000266:history*; D005858:Germany; D006302:Health Services Research / Q000266:history*; D049673:History, 20th Century; D049674:History, 21st Century