Surgical signature describes the striking and persistent differences in the frequency of performance of particular surgical procedures such as prostate operations, back surgery and coronary artery bypass grafting, even among
neighbouring regions with very similar demographic, social and economic characteristics and where the health care systems have similar reimbursement mechanisms. The variations seem to be completely arbitrary and are usually conjectured to arise from physician uncertainty, the absence of agreed protocols and other clinical guidelines, and/or physicians' ignorance of or unwillingness to adopt best practice as determined by senior professional peers. There are also marked variations across jurisdictions, where to 'surgical signature' get added the variety in reimbursement systems, different demographic characteristics, differences in medical education and so on. See Small Area Variations, Supplier-induced Demand.
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