A group of doctors from a range of Boston-area institutions looked at patient outcomes and physician. Their findings were published online via JAMA Inte
rnal Medicine. Abstract here.
While the substantial variation in health care spending across regions and hospitals is well known, key clinical decisions are ultimately made by physicians. However, the degree to which spending varies across physicians and the clinical consequences of that variation are unknown…Health care spending varies more across individual physicians than across hospitals. However, higher physician spending is not associated with better outcomes of hospitalized patients. Our findings suggest policies targeting both physicians and hospitals may be more effective in reducing wasteful spending than policies focusing solely on hospitals.
The new data on physician spending in Medicare align with previous data on geographic variation in spending. Higher spending (reflecting greater utilization of health care services) did not translate into better health outcomes. From this study, we can conclude that differences in the utilization of health care services among hospitalists are not associated with differences in clinical outcomes, adding to the growing body of fascinating research on the complex relationship between spending and health.
