Max Rady College of Medicine
Concept: Low-Variation / High-Variation Hospital Utilization
Last Updated: 1997-02-15
A low-variation / high-variation framework was developed (by
) to identify both medical conditions and surgical procedures for which hospital utilization is fairly stable across small areas ("low-variation") and for which utilization can vary a great deal across small areas ("high-variation"). Rates of hospitalization for high-variation conditions such as pneumonia tend to reflect both physician decision-making (physician practice style) differences in treatment options and the influence of factors other than illness. High-variation conditions thus might serve as indicators, or red flags, for potentially reducible rates of hospitalizations. On the other hand, rates of hospitalization for low-variation conditions tend to reflect the incidence / prevalence of such conditions in the population and a high degree of professional consensus on treatment decisions. They might serve as indicators of necessary hospitalizations.
The most recent low-variation/high-variation format is LHVMS.
A comparison of the most recent information from Dartmouth, New Hampshire (Diagnosis Related Groupings [DRGs™] 1-494, 1994) regarding high-variation/low-variation groupings with the LHVMS format was performed. Aside from the pregnancy/childbirth DRGs (370-391), mental health DRGs (425-432), and DRGs 468, 469, and 477 which were re-assigned for the LHVMS format, the following outlines the differences between the most recent Dartmouth format and the LHVMS format:
* 351 (Sterilization, male) is a high-variation medical condition (the LHVMS format has it as a high-variation surgical procedure (minor)).As well, there are some DRGs that are not currently part of the LHVMS format and have been assigned to variation categories by Dartmouth differently.
* 109 and 474 are no longer valid in DRG 11.
- Roos NP, Mustard CA. Variation in health and health care use by socioeconomic status in Winnipeg, Canada: does the system work well? Yes and no. Milbank Q 1997;75(1):89-111. [Abstract] (View)
- Wennberg JE. Dealing with medical practice variations: a proposal for action. Health Aff (Millwood) 1984;3(2):6-32. [Abstract] (View)
- length of stay
- physician practice patterns
- surgical procedures
Manitoba Centre for Health Policy
Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
Room 408-727 McDermot Ave.
University of Manitoba
Winnipeg, MB R3E 3P5 Canada