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December 11. 2013 7:11PM

Study connects child's zip code, medical care

A child's zip code may be one of the biggest influences on what kind of medical procedures and tests he receives, according to a first-ever study into the variation in treatment decisions across northern New England communities.

Released Wednesday, the report attributes some of the disparity to a child's socioeconomic status. But researchers say "practice styles" of hospitals and doctors are the reasons for much of the disparity.

The result: unneeded care that results in harmful side effects and unnecessary medical bills.

"What parents should be aware of is quality is not the same all over," said Dr. David Goodman, a professor of pediatrics at the Geisel School of Medicine at Dartmouth College and the lead author of the report.

The report was compiled by the Dartmouth Atlas Project, an arm of the Medical School.

The report found much higher use of several procedures in Manchester. The city was tied with Dover for the highest New Hampshire rate of surgical removal of tonsils and adenoids, and it was second for surgical placements of ear-tubes.

It also showed much higher uses of chest X-rays, abdominal X-rays and CT scans, which deliver 200 times the radiation of an X-ray.

The report notes that Manchester and Dover tied for the highest rate of CT head scans in the state, a rate 66 percent higher than Lebanon, the community with the lowest rate.

In a telephone news conference, Goodman said the community boundaries correspond to hospital service areas, and hospitals are responsible for many of the care decisions.

He acknowledged that Manchester has two hospitals, but he said Elliot Hospital provides most of the pediatric care in the Queen City.

Elliot Hospital officials were not available for comment Wednesday. Another hospital spokesman, Jennifer Dearborn at Concord Hospital, said the hospital medical director wouldn't be available until this afternoon.

"The response we would welcome (from) providers is curiosity," Goodman said.

Dartmouth Atlas Project concentrated on northern New England because the three states are among the few in the country that require insurance companies to publicly report payment data. For the last two decades, Dartmouth Atlas Project has tapped publicly available Medicare data to report regional disparities.

Goodman said effective care should be on the radar screen of every parent.

He encouraged parents to ask questions and contact their primary care physician over matters such as CT scans and ear-nose-and-throat surgery.

mhayward@unionleader.com


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