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Chapter 16. Variations in Care

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Variation in clinical practice is evidence of poor-quality care.

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A. Always

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B. Never

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C. Only if the clinical practice is preference sensitive

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D. None of the above

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The three categories of care Wennberg defined for the purpose of studying variation in clinical processes are

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A. warranted, unwarranted, and preference sensitive.

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B. variably used, underused, and overused.

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C. effective, preference sensitive, and supply sensitive.

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D. preference sensitive, supply sensitive, and provider sensitive.

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Variation in a clinical process or outcome is warranted when

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A. it is explained by differences in patient preference, disease prevalence, or other patient- or population-related factors.

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B. it occurs within a provider’s patient population over time but not when it occurs among providers in different geographic regions.

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C. it is explained by physicians’ preferences and habits developed during clinical training.

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D. a control chart plotted for the clinical process or outcome measure shows it to be in statistical control.

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Unwarranted variation in an effective clinical process suggests

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A. the correct rate of use is equal to the average rate of use among all providers.

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B. underuse where this process of care is provided to less than 100% of the patient population in which the evidence shows its benefits outweigh the risks.

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C. there is a need for greater patient involvement in decisions about care.

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D. there is a need for better risk adjustment in the statistical model.

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Which of the following is true?

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A. Special cause variation arises from a single or small set of causes that can be traced and identified

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B. Incidents of special cause variation can be useful in identifying opportunities and targets for quality improvement

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C. Common cause variation cannot be traced to root causes

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D. All of the above are true

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Factors that can contribute to unwarranted variation in use of clinical processes include

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