Are weak or negative clinical recommendations associated with higher geographical variation in utilisation than strong or positive recommendations? Cross-sectional study of 24 healthcare services.

ABSTRACT:

Objectives

When research evidence is lacking, patient and provider preferences, expected to vary geographically, might have a stronger role in clinical decisions. We investigated whether the strength or the direction of recommendation is associated with the degree of geographic variation in utilisation.

Design

In this cross-sectional study, we selected 24 services following a comprehensive approach. The strength and direction of recommendations were assessed in duplicate. Multilevel models were used to adjust for demographic and clinical characteristics and estimate unwarranted variation.

Setting

Observational study of claims to mandatory health insurance in Switzerland in 2014.

Participants

Enrolees eligible for the 24 healthcare services.

Primary outcome m

SUBMITTER: Ulyte A 

PROVIDER: S-EPMC8112440 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature