Health Care Varies Nationwide, Study Finds

The care that patients receive depends in large part on where they live, a comprehensive study by the Dartmouth Medical School says.

The study documents wide variances in medical treatment across the country. It cited some examples:

* The Boston area has almost twice as many hospital beds per capita as the New Haven, Conn., area, though people in Boston don’t get sick twice as often. But the study shows that people in Boston are hospitalized for common conditions such as pneumonia and gastroenteritis that usually are treated outside hospitals in the New Haven area.

* New Orleans had 5.2 hospital beds per 1,000 residents, while Honolulu had 2.2 beds per 1,000 residents. The differences in hospital personnel and hospital expenditures were similar.

* Coronary artery bypass surgery was likely to be used twice as often in Birmingham, Ala.; Little Rock, Ark., or Dayton, Ohio, as it was in Honolulu or Denver.

* Medicare costs per person for fee-for-service care in Miami were at least twice as high as in Lincoln, Neb., or Minneapolis.

People in the health care field were aware of some differences, but “what is shocking is the degree of difference,” said Dr. Jack Lord, a senior advisor for medical affairs of the American Hospital Assn.

The study was done by a team led by Dr. John Wennberg at Dartmouth Medical School.

The study divided the nation into 306 hospital referral regions, based on 1992 and 1993 data on Medicare hospitalizations for major cardiovascular surgery and neurosurgery.