Is more better in orthopaedic surgery?
By James W. Genuario, MD; Samir Mehta, MD; Ryan M. Nunley, MD, and the Washington Health Policy Fellows The United States spent $2 trillion on health care in 2005, or 16 percent of our gross domestic product (GDP). By 2016, the Centers for Medicare and Medicaid Services (CMS) pro-jects healthcare spending to exceed $4 trillion, or 19.6 percent of GDP. To place these figures in context, the United States spent four times more on health care in 2005 than it did on education ($536 billion spent on education for grades K through 12). For years, the U.S. healthcare system has operated on the theory that spending more on health care equals better patient outcomes. However, this proposition is being challenged as researchers analyze the discrepant rates of spending across the country. Geographic variations in care John E. Wennberg, MD, MPH, first began examining healthcare variations using a system of small area analysis, dividing up the country into discrete hospital referral areas. After co
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