For more than 20 years, the Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. The project uses Medicare data to provide comprehensive information and analysis about national, regional, and local markets, as well as individual hospitals and their affiliated physicians.

This report updates previous findings regarding variations in end-of-life care and documents trends from 2003 to 2007 in the use of medical resources to treat Medicare patients at the end of life.
Click to access the report or press release.

In 2008 San Francisco implemented major health reform, becoming the first city to adopt a pay-or-play employer health spending mandate. It also created Healthy San Francisco, a new “public option” low-cost health access plan for the uninsured. This study evaluates employer-level health benefit offering responses to the pay-or-play mandate in the first year of implementation using the 2008 Bay Area Employer Health Benefits Survey and a difference-in-difference estimator. To read more, click here.

Whether Medicare patients with advanced cancer will die while receiving hospice care or in the hospital varies markedly depending on where they live and receive care, according to the Dartmouth Atlas Project's first-ever report on cancer care at the end of life. The report demonstrates no consistent pattern of care or evidence that treatment patterns follow patient preferences, even among the nation's leading academic medical centers. Read the press release or view the full report.

Geographic Variation in Diagnosis Frequency and Risk of Death Among Medicare Beneficiaries. Welch HG, Sharp SM, Gottlieb DJ, Skinner JS, Wennberg JE. JAMA 2011; 305(11):1113-8. Link

Seniors' Perceptions Of Health Care Not Closely Associated With Physician Supply. David J. Nyweide, Denise L. Anthony, Chiang-Hua Chang and David Goodman Health Affairs, 30, no.2 (2011):219-227 Article

Trends and variation in incidence, surgical treatment, and repeat surgery of proximal humeral fractures in the elderly. Bell JE, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, Tosteson AN. J Bone Joint Surg Am. 2011 Jan;93(2):121-31. Article

Geographic Maldistribution of Primary Care for Children. Shipman SA, Lan J, Chang CH, Goodman DC.  Pediatrics. Published online December 20, 2010 Link

Measuring Racial Disparities in the Quality of Ambulatory Diabetes Care. Bynum JP, Fisher ES, Song Y, Skinner J, Chandra A. Med Care 2010 Dec;48(12):1057-63. Link

Supply Sensitive Services in Swiss Ambulatory Care: An Analysis of Basic Health Insurance Records for 2003-2007. Busato A, Matter P, Künzi B, Goodman DC. BMC Health Serv Res 2010 Nov 23;10:315. Article

Race versus Place of Service in Mortality among Medicare Beneficiaries with Cancer. Onega T, Duell EJ, Shi X, Demidenko E, Goodman DC. Cancer 2010;116(11):2698–706. Link