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Variation in day surgery among Dutch hospitals: the development of a theoretical model to explain variations.

Kroneman, M., Oort, M. van, Groenewegen, P., Jong, D. de. Variation in day surgery among Dutch hospitals: the development of a theoretical model to explain variations. Ambulatory Surgery: 2003, 10(2), 73-79
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The aim of this paper is providing a first step in explaining variations in day surgery rates among Dutch hospitals. A theoretical model was set up to explain variations based on diffusion theory and environmental characteristics. We tried to test our model by means of routinely collected data from administrative databases. The S-shaped curve of diffusion could be shown combining data on laparoscopic cholecystectomies (early phase of adoption), cataract surgery (middel phase) and curettage and dilatation (late phase of adoption). The theoretical model was translated into a regression model for the latter two procedures. The routinely collected data appeared not adequate to test our hypotheses. The data were available only at hospital level. Probably more detailed data on physician partnerships and hospital circumstances are needed to adequately test our hypotheses. (aut. ref.)