Factors Related to the Treatment of Gallbladder Disease

摘要

This research explores the factors related to cholecystectomy rates in medical groups of the Health Insurance Plan of Greater New York and estimates the propotion of patients with gallbladder disease who were operated on within a 3 to 4 year period after first diagnosis. Comparison of HIP cholecystectomy rates with total U.S. rates showed that the HIP rate for men was about 3/5 of that for all U.S. men, while for women the HIP rate was less than half the U.S. rate. The rates were higher for women than for men, and increased with age for each sex. Among the 28 HIP medical groups cholecystectomy rates ranged from a low of 0.3 to a high of 1.9 procedures per 1,000 prsons. No outstanding correlates of cholecystectomy rates were found within the medical groups of HIP. The factors considered as possible influences on the variation were primarily rates for other types of medical service in the groups. Groups with higher rates also had higher rates for other services; age and qualifications of surgeons did not differ; in the high rate groups, surgeons tended to use fewer hospitals for their cholecystectomies, and the authors speculate that this may indicate greater control over and thus easier access to hospital beds.