Location a key for U.S. surgery

LEBANON, N.H., Feb. 24 (UPI) -- Whether a U.S. patient gets surgery for an ailment can vary greatly by location, researchers say.

A report from the Dartmouth Atlas Project and the Foundation for Informed Medical Decisions found wide regional variations in elective surgery for Medicare patients even though they had similar conditions.

For example, Medicare patients in Ohio 10 times more likely to get angioplasty than in Honolulu. Men age 65 with early-stage prostate cancer who live in San Luis Obispo, Calif., are 12 times more likely to have surgery to remove their prostate than those in Albany, Ga. Or, women age 65 and older living in Victoria, Texas, are seven times more likely to undergo mastectomy for early-stage breast cancer than women in Muncie, Ind.

"These striking variations are the by-product of a doctor-centric medical delivery system," lead author Shannon Brownlee of the Dartmouth Institute for Health Policy and Clinical Practice says in a statement.

"In highlighting the variation from community to community for elective procedures, we hope to shine a light on the fact that patients' preferences are not always taken into account when medical decisions are made."

Patients facing elective surgery "all too often" are not told the full range of options open to them, along with the risk and benefits of each, said Dr. David C. Goodman, report co-author for the project, and director of the Center for Health Policy Research at the Dartmouth Institute for Health Policy and Clinical Practice.

"Many are not even aware that the decision about an elective procedure is actually a choice," he said. "Instead, they routinely delegate such important decisions to their clinicians, with the result being that patients often do not get the treatment they would prefer."