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You have full text access to this contentGeographic Variation in Quality of Care for Commercially Insured Patients

Background: Extensive evidence documents geographic variation in spending, but limited research assesses geographic variation in quality, particularly among commercially insured enrollees.

Objective: To measure geographic variation in quality measures, correlation among measures, and correlation between measures and spending for commercially insured enrollees.

Data Source: Administrative claims from the 2007–2009 Truven MarketScan database.

Methods: We calculated variation in, and correlations among, 10 quality measures across 306 Hospital Referral Regions (HRRs), adjusting for beneficiary traits and sample size differences. Further, we created a quality index and correlated it with spending.

Results: The coefficient of variation of HRR-level performance ranged from 0.04 to 0.38. Correlations among quality measures generally ranged from 0.2 to 0.5. Quality was modestly positively related to spending.

Conclusion: Quality varied across HRRs and there was only a modest geographic “quality footprint.”

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