Temporal Patterns in the Use of Health Services Leading to Cholecystectomy: A Process Evaluation Using Insurance Records

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Data from Saskatchewan's public medical and hospital insurance programs are used to estimate a multivariate model of health services utilization among cholecystectomy patients. A methodology is developed which partitions the care process into an assessment period, a waiting period, and a hospitalization period. The general hypothesis is that presurgical and surgical decisions of physicians are influenced by extra-medical factors, including the social condition of the patient and the availability of health resources. This hypothesis is only weakly supported by the data.

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