JMIR Publications

ABSTRACT

Background:

One of the greatest challenges of modern health systems is the choice and use of resources needed to diagnose and treat patients. Medical practice variation (MPV) is a broad term which entails the differences between healthcare providers inclusive of both the overuse and underuse. In this paper we describe a three-phase research protocol examining MPV in primary care.

Objective:

We aim to identify the potential targets for behavioral modification interventions to reduce the variation in practice patterns and thus improve healthcare, decrease costs and prevent disparities in care.

Methods:

The first phase will delineate the variation in primary care practice over a wide range of services and long follow-up period (2003-2017), the second will examine the three determinants of variation (i.e., patient, physician and clinic characteristics) and attempt to derive the unexplained variance. In the third phase, we will assess a novel component that might contribute to the previously unexplained variance – the physicians’ personal behavioral characteristics such as risk aversion, fear of malpractice, stress from uncertainty, empathy and burnout.

Results:

This work was supported by the research grant from Israel National Institute for Health Policy Research (2014/134/). Soroka University Medical Center Institutional Ethics Committee has approved the study protocol (SOR-14-0063) named in February 2019. The data for the phase 1 and 2 were collected in 2019 and are currently analyzed. The evaluation of the individual physician characteristics (e.g. risk aversion) by the face-to-face questionnaires was finished in 2020. We intend to publish the results during 2020-2021.

Conclusions:

Based on the results of our study, we aim to propose a list of potential targets for focused behavioral intervention. We believe that identifying new targets for such an intervention can potentially lead to a decrease in the unwarranted variation in the medical practice. Thus, to bring into the optimization of the health system, improvement of health outcomes, reduction of disparities in care and save in costs.