Multidimensional analysis as a tool for measuring diversity in the availability of outpatient care

Aim: To demonstrate how multidimensional analysis can be used as a statistical tool for assessing the practices of healthcare professionals and consequently, the availability of healthcare for a medical specialty within a given geographic area. Method: We studied a cohort of cardiologists engaged in outpatient practice for a complete year who dispensed care to at least 200 different patients between July 1, 2001 and June 30, 2002. We analyzed their professional practices by using a number of active and demonstrative variables which were mainly chosen from the national health-fund’s catalogue of reimbursable acts. We analyzed the principal components followed by a hierarchical cluster analysis. Results: The cardiologists were divided into eight classes. Although each one practiced in a different manner, their activity generally fulfilled expected expectations. Some of the cardiologists functioned as consultants while others either mainly followed their own outpatients, performed some surgery or engaged in interventional cardiology. These different types of activity were unequally distributed over the geographic area studied. Conclusion: The selection of which variables to include in a model constitutes a decisive, preliminary stage. Multidimensional analysis appears to be welladapted to assess the diversity of the healthcare available in a given geographic area and illustrates that we can no longer consider that a particular medical specialty constitutes a homogenous entity.