Improving Patient Decision-Making: New England Region

In this Dartmouth Atlas report, the first in a series of nine U.S. regional reports, we show the wide regional variation in the likelihood that patients with similar  conditions receive elective procedures. This report highlights the New England region (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) and shows the variation across the region and the United States.

For patients whose conditions can be treated with elective surgery, location matters. For example, if you have heart disease and live in Winsted, Connecticut, you are half as likely to undergo balloon angioplasty than if you live in Marlborough, Mass., and more than twice as likely to undergo back surgery than if you live in Manchester, N.H. If you have osteoarthritis of the knee and live in Calais, Maine, you are twice as likely to have your knee replaced than if you live in Providence, R.I.

This report, a collaborative project with the Informed Medical Decisions Foundation, looks at the variation in surgical rates in 306 hospital referral regions across the United States (a hospital referral region is a large health care market containing at least one referral hospital).