Michael Zubkoff

TL;DR: The Medical Outcomes Study was designed to determine whether variations in patient outcomes are explained by differences in system of care, clinician specialty, and clinicians' technical and interpersonal styles and develop more practical tools for the routine monitoring of patient outcomes in medical practice.

TL;DR: The evidence reviewed here supports the hypothesis that variations occur to a large extent because of differences among physicians in their evaluation of patients or in their belief in the value of the procedures for meeting patient needs.

TL;DR: Although variations in patient mix should be a major determinant of variations in resource use, the independent effects of specialty training, payment system, and practice organization on utilization rates need further explication.

TL;DR: It is concluded that new measures are needed to assess function in a busy office practice and that the COOP Chart system represents one promising strategy.

TL;DR: Patient mix is related to utilization and differs significantly across medical specialties and systems of care and must be taken into account when interpreting variations in utilization and outcomes across specialty and systems, and when considering alternative policies for payment.