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Previous Volume 348:2681-2683 June 26, 2003 Number 26 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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It has been 30 years since Wennberg and Gittelsohn published their landmark article demonstrating substantial variation among different geographic areas in the provision of medical services.¹ Since then, investigators have found variation in the delivery of virtually every aspect of health care that has been examined. From the perspective of the quality of care, the variation that is the greatest cause for concern is that between actual practice and evidence-based "best practice."

Over the past 30 years, progress has been made in several areas that are vital to quality improvement. Practice guidelines have become more rigorously evidence-based and are now . . . [Full Text of this Article]

Source Information

From Resolution Health, San Jose, Calif.; and the Departments of Medicine and Health Policy and Management, Johns Hopkins University, Baltimore.

Related Letters:

Quality of Health Care Delivered to Adults in the United States
Spiegel M., Pechlaner C., Goss J. R., Elmore J. G., Lessler D. S., Sheikh K., Basch P., McGlynn E. A., Asch S. M., Kerr E. A., Steinberg E. P.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:1866-1868, Nov 6, 2003. Correspondence

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