elcome to the Dartmouth Atlas of Health Care in Michigan, a groundbreaking study by John E. Wennberg, MD, MPH, and David Wennberg, MD, MPH, developed in partnership with Blue Cross Blue Shield of Michigan. Dr. John Wennberg earned international acclaim for his previous research on the use of health care services by the Medicare population.

The Michigan atlas is the most extensive study of its kind of medical care in the state. Dr. Wennberg and his associates used Blues' claims data and information from other sources to analyze the use and supply of health care services in Michigan. The data was provided in such a way as to protect the confidentiality of individual Blues members but to allow for analysis based on geographical areas.

The Dartmouth Atlas does not provide any answers. Instead, it points to important questions about how health care services are used throughout the state, and why this use may vary among communities.

The Blues commissioned the Dartmouth Atlas of Health Care in Michigan as a way to open a statewide discussion about the quality of health care. The atlas findings will be shared with communities throughout the state in hopes of developing a better understanding of variation in the use of health care services and working with communities to enhance the quality of health care. The Blues plan to accomplish this over the next several months through use of this Web site and personal presentations.

These initial discussions will be followed by in-depth dialogue and improvement activities in several Michigan communities. The Blues will work collaboratively with physicians, hospitals, employers, labor unions and consumers in this ongoing effort.

We've made the atlas available to a broad audience by releasing sections on a regular basis since April on this Web site. You are welcome to print personal copies of each segment. The complete atlas is available for purchase in soft cover version. You may order your copy by following the Order Form link.

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NOTICE TO ATLAS READERS
While not giving answers, the atlas raises questions about health care service use that merit careful consideration. "High" rates of use are not necessarily bad and "low" volumes good (or vice versa). Our goal is to move toward rates that are consistent with high quality health care, which need to be determined with local clinical, community and patient discussion and dialogue.

The atlas is not a physician or hospital report card. When reviewing data, note that the Hospital Service Areas in the atlas were defined by the atlas author. They may differ significantly from what a hospital considers its market area.