Applying productivity information to control unwarranted variation in healthcare

Healthcare costs are rising across developed nations. Increasing demand for the delivery and maintenance of healthcare due to an aging population and increasing prevalence of chronic conditions fuel growth in costs. Scientific and technological advancements further aggravate the escalation of costs by enhancing the supply of treatments and expensive diagnostics. This recipe for unsustainability mandates responsible stewardship in resources across all levels of a given healthcare system. Despite reforms, large differences in cost of care continue to persist between and within countries and even institutions. Part of the variation is explained by the severity of illness, patient preferences or available organizational infrastructure. A large part of the variation, however, remains unexplained and is characterized as unwarranted. Physician practice style is the main reason for its existence and persistence. This dissertation sets out to intervene to answer the following research question: How can accounting-based control interventions at the physician-level reduce unwarranted variation?