Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending
There is considerable controversy about the causes of regional variations in health care expenditures. We use vignettes from patient and physician surveys linked to fee-for-service Medicare expenditures to test whether patient demand-side factors or physician supply-side factors explain regional variations in spending. We find patient demand is relatively unimportant in explaining variation in spending after accounting for physician beliefs. Physician organizational factors matter, but the single most important factor is physician beliefs about treatment: 35 percent of Medicare end-of-life spending, 12 percent of spending for heart attack patients, and 12 percent of total Medicare spending, are associated with physician beliefs unsupported by clinical evidence.
|Date of creation:||Aug 2013|
|Note:||AG HC HE|
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- Amitabh Chandra & Douglas O. Staiger, 2007. "Productivity Spillovers in Health Care: Evidence from the Treatment of Heart Attacks," Journal of Political Economy, University of Chicago Press, vol. 115, pages 103-140.
- Mark Pauly, 1980. "Appendix to "Doctors and Their Workshops: Economic Models of Physician Behavior"," NBER Chapters,in: Doctors and Their Workshops: Economic Models of Physician Behavior, pages 119-122 National Bureau of Economic Research, Inc.
- Jeffrey Clemens & Joshua D. Gottlieb, 2014.
"Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?,"
American Economic Review,
American Economic Association, vol. 104(4), pages 1320-1349, April.
- Jeffrey Clemens & Joshua D. Gottlieb, 2012. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," Discussion Papers 11-017, Stanford Institute for Economic Policy Research.
- Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
- Mark Pauly, 1980. "Doctors and Their Workshops: Economic Models of Physician Behavior," NBER Books, National Bureau of Economic Research, Inc, number paul80-1, June.
- Doyle Jr., Joseph J. & Ewer, Steven M. & Wagner, Todd H., 2010. "Returns to physician human capital: Evidence from patients randomized to physician teams," Journal of Health Economics, Elsevier, vol. 29(6), pages 866-882, December.
- Epstein, Andrew J. & Nicholson, Sean, 2009. "The formation and evolution of physician treatment styles: An application to cesarean sections," Journal of Health Economics, Elsevier, vol. 28(6), pages 1126-1140, December.
- Andrew Epstein & Sean Nicholson, 2005. "The Formation And Evolution Of Physician Treatment Styles: An Application To Cesarean Sections," Working Papers id:176, eSocialSciences.
- Andrew Epstein & Sean Nicholson, 2005. "The Formation and Evolution of Physician Treatment Styles: An Application to Cesarean Sections," NBER Working Papers 11549, National Bureau of Economic Research, Inc.
- Jonathan Gruber & Maria Owings, 1996. "Physician Financial Incentives and Cesarean Section Delivery," RAND Journal of Economics, The RAND Corporation, vol. 27(1), pages 99-123, Spring.
- Jonathan Gruber & Maria Owings, 1994. "Physician Financial Incentives and Cesarean Section Delivery," NBER Working Papers 4933, National Bureau of Economic Research, Inc.
- John Ameriks & Andrew Caplin & Steven Laufer & Stijn Van Nieuwerburgh, 2011. "The Joy of Giving or Assisted Living? Using Strategic Surveys to Separate Public Care Aversion from Bequest Motives," Journal of Finance, American Finance Association, vol. 66(2), pages 519-561, 04.
- Anna A. Levine Taub & Anton Kolotilin & Robert S. Gibbons & Ernst R. Berndt, 2011. "The Diversity of Concentrated Prescribing Behavior: An Application to Antipsychotics," NBER Working Papers 16823, National Bureau of Economic Research, Inc.
- Dranove, David & Wehner, Paul, 1994. "Physician-induced demand for childbirths," Journal of Health Economics, Elsevier, vol. 13(1), pages 61-73, March. Full references (including those not matched with items on IDEAS)
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