Judith D. de Jong: 'Explaining medical practice variation-Social organization and institutional mechanisms,' Utrecht, 2007

摘要

In the last 15 years, the quality movement has addressed the variation between medical practices at all levels: between physicians within the same department, between departments, between hospitals and between countries. Variation is something like the smoke in the heurism: "Where there is smoke, there is fire": if medical decision making is rational, how can there be variation in practice? However, the issue of medical practice variation has long drawn attention from researchers from outside the quality movement. Researchers assuming social conditions, financial incentives or training are interested in variation. Of course, policy makers are stakeholders in this variation debate. Judith de Jong (2007) studies variation following Freidson (1975) and Westert and Groenewegen (1999), assuming that especially social conditions influence physicians' medical behavior.