Evidence map›Paper›PMID 35573484›Full record

ArticleHealth services research and managerial epidemiology

Small Area Variation of Adherence to Clinical Recommendations: An Example from Switzerland.

Oliver Gruebner, Wenjia Wei, Agne Ulyte, Viktor von Wyl, Holger Dressel, Beat Brüngger, Caroline Bähler, Eva Blozik, Matthias Schwenkglenks

Abstract read
In one paragraph

Article in Health services research and managerial epidemiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Oliver GruebnerEpidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0001-9783-4770
Wenjia WeiEpidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
Agne UlyteEpidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
Viktor von WylEpidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
Holger DresselEpidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
Beat BrünggerDepartment of Health Sciences, Helsana Insurance Group, Zurich, Switzerland.ORCID https://orcid.org/0000-0001-6173-5375
Caroline BählerDepartment of Health Sciences, Helsana Insurance Group, Zurich, Switzerland.
Eva BlozikInstitute of Primary Care, University of Zurich, Zurich, Switzerland.
Matthias SchwenkglenksEpidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Unwarranted variation in healthcare utilization can only partly be explained by variation in the health care needs of the population, yet it is frequently found globally. This is the first cross-sectional study that systematically assessed geographic variation in the adherence to clinical recommendations in Switzerland. Specifically, we explored 1) the geographic variation of adherence to clinical recommendations across 24 health services at the sub-cantonal level, 2) assessed and mapped statistically significant spatial clusters, and 3) explored possible influencing factors for the observed geographic variation. Methods: Exploratory spatial analysis using the Moran's I statistic on multivariable multilevel model residuals to systematically identify small area variation of adherence to clinical recommendations across 24 health services. Results: Although there was no overall spatial pattern in adherence to clinical recommendations across all health care services, we identified health services that exhibited statistically significant spatial dependence in adherence. For these, we provided evidence about the locations of local clusters. Interpretation: We identified regions in Switzerland in which specific recommended or discouraged health care services are utilized less or more than elsewhere. Future studies are needed to investigate the place-based social determinants of health responsible for the sub-cantonal variation in adherence to clinical recommendations in Switzerland and elsewhere over time.

Indexed as

access to health careclinical guidelineshealth care utilizationspatial analysisunwarranted variation

Identifiers

PMID35573484
PMCPMC9102215

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.