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Health Services Researchers' Use of the Dartmouth Atlas of Health Care: A Literature Review and Network Analysis 1996-2023.

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Title: Health Services Researchers' Use of the Dartmouth Atlas of Health Care: A Literature Review and Network Analysis 1996-2023.
Authors: Zhang, Jingyi1 (AUTHOR), Fanouraki, Eleni1 (AUTHOR), Alagappan, Uma1 (AUTHOR), Drill, Carleigh1 (AUTHOR), Nagpal, Pulkit1 (AUTHOR), Bobak, Carly2,3 (AUTHOR), Lakkireddy, Sai4 (AUTHOR), Wernimont, Jacqueline D.5 (AUTHOR), Barnato, Amber E.1,6 (AUTHOR) amber.barnato@dartmouth.edu
Source: Inquiry (00469580). 10/18/2025, Vol. 62, p1-10. 10p.
Subject Terms: *Academic medical centers, *Reference books, *Authorship, *Chronic diseases, *Experimental design, *Bibliometrics, *Social networks, Medical care research, Serial publications, Grey literature, Medical quality control, Medical care, Medicare, Fee for service (Medical fees), Population geography, Publishing, Geographic information systems, Health equity, Medical care costs
Abstract: The Dartmouth Atlas of Health Care published data on regional variations in healthcare for Medicare fee-for-service beneficiaries from 1996 to 2022. Despite its revolutionary impact on health services research and policymaking, to our knowledge, no comprehensive review has been undertaken to systematically study how the Dartmouth Atlas has been used by the research community. We identified all 8507 publications that cited the Dartmouth Atlas between 1996 and 2023. With this corpus, we conducted authorship network analyses and conducted a content analysis of a 5% random sample (n = 403). Network analyses showed a high degree of co-author clustering and little cross-community co-authorship. Content analysis showed that most publications had no author affiliation with Dartmouth (88%, 95% CI = 0.85-0.91), were quantitative observational studies (51%, 95% CI = 0.47-0.57), and cited the Dartmouth Atlas without using its data (71%, 95% CI = 0.67-0.76). Among the 29% publications (n = 116) that directly used Dartmouth Atlas data, most (76%, 95% CI = 0.67-0.83) used the crosswalk tool to define geographic units, and many (45%, 95% CI = 0.36-0.54) used the data as variables in hypothesis testing. Most studies did not acknowledge the data limitations of the Dartmouth Atlas when using its data, though more acknowledged similar limitations for their overall study design that also involved Medicare fee-for-service data. Our results demonstrated the wide impact of the Dartmouth Atlas and suggested potential opportunities for improving data users' understanding of the critical assumptions in producing the Dartmouth Atlas data. [ABSTRACT FROM AUTHOR]
Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Health Services Researchers' Use of the Dartmouth Atlas of Health Care: A Literature Review and Network Analysis 1996-2023.
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  Data: <searchLink fieldCode="AR" term="%22Zhang%2C+Jingyi%22">Zhang, Jingyi</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fanouraki%2C+Eleni%22">Fanouraki, Eleni</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Alagappan%2C+Uma%22">Alagappan, Uma</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Drill%2C+Carleigh%22">Drill, Carleigh</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nagpal%2C+Pulkit%22">Nagpal, Pulkit</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bobak%2C+Carly%22">Bobak, Carly</searchLink><relatesTo>2,3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lakkireddy%2C+Sai%22">Lakkireddy, Sai</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wernimont%2C+Jacqueline+D%2E%22">Wernimont, Jacqueline D.</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barnato%2C+Amber+E%2E%22">Barnato, Amber E.</searchLink><relatesTo>1,6</relatesTo> (AUTHOR)<i> amber.barnato@dartmouth.edu</i>
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  Data: <searchLink fieldCode="JN" term="%22Inquiry+%2800469580%29%22">Inquiry (00469580)</searchLink>. 10/18/2025, Vol. 62, p1-10. 10p.
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  Data: *<searchLink fieldCode="DE" term="%22Academic+medical+centers%22">Academic medical centers</searchLink><br />*<searchLink fieldCode="DE" term="%22Reference+books%22">Reference books</searchLink><br />*<searchLink fieldCode="DE" term="%22Authorship%22">Authorship</searchLink><br />*<searchLink fieldCode="DE" term="%22Chronic+diseases%22">Chronic diseases</searchLink><br />*<searchLink fieldCode="DE" term="%22Experimental+design%22">Experimental design</searchLink><br />*<searchLink fieldCode="DE" term="%22Bibliometrics%22">Bibliometrics</searchLink><br />*<searchLink fieldCode="DE" term="%22Social+networks%22">Social networks</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+research%22">Medical care research</searchLink><br /><searchLink fieldCode="DE" term="%22Serial+publications%22">Serial publications</searchLink><br /><searchLink fieldCode="DE" term="%22Grey+literature%22">Grey literature</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+quality+control%22">Medical quality control</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care%22">Medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Medicare%22">Medicare</searchLink><br /><searchLink fieldCode="DE" term="%22Fee+for+service+%28Medical+fees%29%22">Fee for service (Medical fees)</searchLink><br /><searchLink fieldCode="DE" term="%22Population+geography%22">Population geography</searchLink><br /><searchLink fieldCode="DE" term="%22Publishing%22">Publishing</searchLink><br /><searchLink fieldCode="DE" term="%22Geographic+information+systems%22">Geographic information systems</searchLink><br /><searchLink fieldCode="DE" term="%22Health+equity%22">Health equity</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+costs%22">Medical care costs</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: The Dartmouth Atlas of Health Care published data on regional variations in healthcare for Medicare fee-for-service beneficiaries from 1996 to 2022. Despite its revolutionary impact on health services research and policymaking, to our knowledge, no comprehensive review has been undertaken to systematically study how the Dartmouth Atlas has been used by the research community. We identified all 8507 publications that cited the Dartmouth Atlas between 1996 and 2023. With this corpus, we conducted authorship network analyses and conducted a content analysis of a 5% random sample (n = 403). Network analyses showed a high degree of co-author clustering and little cross-community co-authorship. Content analysis showed that most publications had no author affiliation with Dartmouth (88%, 95% CI = 0.85-0.91), were quantitative observational studies (51%, 95% CI = 0.47-0.57), and cited the Dartmouth Atlas without using its data (71%, 95% CI = 0.67-0.76). Among the 29% publications (n = 116) that directly used Dartmouth Atlas data, most (76%, 95% CI = 0.67-0.83) used the crosswalk tool to define geographic units, and many (45%, 95% CI = 0.36-0.54) used the data as variables in hypothesis testing. Most studies did not acknowledge the data limitations of the Dartmouth Atlas when using its data, though more acknowledged similar limitations for their overall study design that also involved Medicare fee-for-service data. Our results demonstrated the wide impact of the Dartmouth Atlas and suggested potential opportunities for improving data users' understanding of the critical assumptions in producing the Dartmouth Atlas data. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1177/00469580251382062
    Languages:
      – Code: eng
        Text: English
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        PageCount: 10
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    Subjects:
      – SubjectFull: Academic medical centers
        Type: general
      – SubjectFull: Reference books
        Type: general
      – SubjectFull: Authorship
        Type: general
      – SubjectFull: Chronic diseases
        Type: general
      – SubjectFull: Experimental design
        Type: general
      – SubjectFull: Bibliometrics
        Type: general
      – SubjectFull: Social networks
        Type: general
      – SubjectFull: Medical care research
        Type: general
      – SubjectFull: Serial publications
        Type: general
      – SubjectFull: Grey literature
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      – SubjectFull: Medical quality control
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      – SubjectFull: Medical care
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      – SubjectFull: Medicare
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      – SubjectFull: Fee for service (Medical fees)
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      – SubjectFull: Population geography
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      – SubjectFull: Publishing
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      – SubjectFull: Geographic information systems
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      – SubjectFull: Health equity
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      – SubjectFull: Medical care costs
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              Text: 10/18/2025
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