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Reflections on Geographic Variations in U.S. Health Care

With funding from the National Institutes for Health and not-for-profit foundations, the goal of the Dartmouth research team has been to improve our understanding of the causes and consequences of variation in the way health care is delivered around the country. Why do some primary care physicians order more than twice as many CT scans as their colleagues in the same practice? Why are the rates of coronary stents three times higher in Elyria, Ohio, compared with nearby Cleveland, home of the famous Cleveland Clinic? And most importantly – what do these differences mean for patients? The aim of the research is to advance the science of health care delivery – to understand what actually happens to patients and what can be done to make care better.