Multimedia

Lectures

Unwarranted Variations and Their Remedies: Findings from the Dartmouth Atlas of Health Care
The overuse, underuse, and misuse of medical care in the United States. Interventions that are of little value are commonly overused; care that is effective is commonly underused; and care that is of unproved value is frequently misused. Spending on medical interventions continues to increase without evidence that doing more results in better outcomes or better patient satisfaction.
      Introduction
      Part 1
      Part 2
      Part 3
      Part 4

Is More Better?
This presentation by Dr. Elliott S. Fisher argues that, if more intense intervention does not improve life expectancy, and if most patients prefer less care when more intensive care is likely to be futile, then we must conclude that large amounts of money are spent on medical interventions that provide no benefit.
      Is More Better?

Medicare Reform: Improving Fairness and Efficiency
This presentation by Dr. Jonathan Skinner asks, what are we getting for our investment in the very aggressive care provided to some Medicare enrollees? High levels of spending do not appear to have yielded a discernible improvement in either life expectancy or quality of life. How can Medicare be fixed to improve both efficiency and fairness?
      Medicare Reform: Improving Fairness and Efficiency


Videos

Windows on Health Care: The Faces of Variations
This hour-long video program discussing the history and importance of variations is available in 15-minute streaming video segments.
      Part 1
      Part 3
      Part 2
      Part 4

Introduction to Variations:
This short segment discusses regional variations and the importance of shared decision-making.
      Introduction to Variations

LifeLine: Geographic Destiny
This segment from NBC Nightly News (October 4, 2000) discusses regional variations in surgery rates and shared decision-making.
      Geographic Destiny

Focus: The Sun City Choice
This segment from NewsHour with Jim Lehrer (September 10, 1999) focuses on end-of-life care in the retirement community of Sun City, Arizona. A transcript is available here.
      The Sun City Choice


SPOTLIGHT
    • Improving Patient Decision-Making in Health Care: A 2012 Dartmouth Atlas Series

    • Medicine involves decisions. But for Medicare patients with conditions for which surgery is an option, whether they undergo elective surgery depends largely on where they live and the clinicians they see. A new series of reports looks at the variation in surgical rates in 306 hospital referral regions across the United States. Each report highlights one of nine regions and shows the variation that exists even across these smaller geographic areas.

    • Read More
    • What Kind of Physician Will You Be? Variation in Health Care and Its Importance for Residency Training

    • When choosing a residency program, medical students typically consider the reputation and training curriculum of the institution, as well as their own geographical and lifestyle preferences. But there's something else they should consider: The way academic medical centers deliver health care differs dramatically from one institution to the next.

    • Read More
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The Dartmouth Atlas of Health Care is based at The Dartmouth Institute for Health Policy and Clinical Practice and is supported by a coalition of funders led by the Robert Wood Johnson Foundation, including the WellPoint Foundation, the United Health Foundation, the California HealthCare Foundation, and the Charles H. Hood Foundation.

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