A population-based analytical approach to assessing patterns, determinants, and outcomes of health care with application to ectopic pregnancy

OBJECTIVE. Health care has variable features, specific determinants, and co nsequences on people's health that should be investigated in a population p erspective. We present a population-based analytical approach to assessing patterns, determinants, and outcomes of health care. METHODS. The approach uses standard epidemiological methods for sample sele ction and analysis, as well as statistical methods concerning model fitting and validation strategy. It also uses psychometric methods allowing patter n identification: factor analysis, cluster analysis, and polytomous logisti c regression to investigate the factors associated with identified patterns of care. The approach is illustrated with an application to ectopic pregna ncy (EP). RESULTS. EP diagnostic and therapeutic procedures appeared to be closely re lated, suggesting 3 differentiated patterns of care. Predictors of these pa tterns were not only the clinical features and the woman's prior gynecologi cal history but also center characteristics and location. These patterns we re found to influence immediate and middle-term outcomes and risk of recurr ence of EP. CONCLUSIONS. We illustrate the feasibility and profitability of a populatio n-based analytical approach to identify patterns, determinants, and consequ ences of care. This approach could be used to analyze other pathological co nditions and health care systems.