title: Health System Perspective: Variation, Costs, and Physician Behavior.
abstract: With the generalized rise in cost of US health care, renewed emphasis has been placed on defining the relationship between costs and outcome. The quality of health care delivery has been uneven, as measured by existing quality and performance measures, significant variation in the delivery of care, lack of standardization of care leading to avoidable error, lack of meaningful outcomes measurement, and apparent disconnect with cost. Orthopaedic surgeons are at the nexus of implementing change, as we are the primary decision makers regarding care of our patients. This summary will review efforts that address quality, cost, outcome, safety, and variation in care.
authors.affiliation: Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
authors.forename: David S
authors.initials: DS
authors.lastname: Jevsevar
mesh_terms: D002648:Child; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000592:standards / Q000639:trends; D055317:Evidence-Based Practice / Q000639:trends; D006801:Humans; D009985:Orthopedics / Q000379:methods / Q000592:standards; D017063:Outcome Assessment, Health Care; D010819:Physician's Role; D058996:Quality Improvement; D012015:Reference Standards; D014481:United States