Studies on hospital use have been conducted in other centres. One example was a study that compared hospital use rates by residents of Boston, Massachusetts, many of whom are served by Harvard Medical School, with those of New Haven, Connecticut, served by equally highly regarded Yale Medical School. Boston residents spent 44% more days in hospital and almost twice as much per capita on hospital use than did New Haven residents, with no detectable difference in health outcomes. Even more surprising, physicians in the two cities were unaware that they were practicing under either abundant or constrained circumstances (Wennberg, et al., 1987, 1989).Closer to home, the Saskatchewan Health Services Utilization and Research Commission reviewed the characteristics of patients admitted to hospital to determine if patients required the technology and high-intensity services characteristic of acute hospitals. Thirty-nine percent of adult medical patients admitted to larger Saskatchewan hospitals did not require acute hospital services, although they often required some form of service, such as outpatient (hospital treatment without an overnight stay), long term care or home care. In rural hospitals, the percentage was even higher. We are beginning a similar study here.