Higher Spending Physicians Do Not Achieve Better Outcomes

doctor wearing blue tie holding piggybank
doctor wearing blue tie holding piggybank
Study examined average physician spending using a random sample of Medicare patients.

HealthDay News — Medicare patients treated by higher-spending physicians are just as likely to be re-admitted or die within 30 days of being admitted to the hospital as patients treated by doctors who order fewer or less-expensive tests and treatments, according to a study published online March 13 in JAMA Internal Medicine.

Investigators looked at average physician spending using a random sample of Medicare patients, aged 65 and older, who were hospitalized for a non-elective condition. The analysis focused on general internists and hospitalists. Physician spending was calculated using 2011 and 2012 data and then applied to patient outcomes in 2013 and 2014.

The researchers found that spending across physicians in a single hospital varied more than across hospitals, even after accounting for differences between hospitals and patient populations. 

Overall, 8.4% of the spending variation could be explained by differences between physicians, while 7.0% was associated with differences between hospitals. Higher spending didn’t result in better outcomes. The researchers said they found no difference in 30-day re-admissions or patient deaths.

“Our findings suggest policies targeting both physicians and hospitals may be more effective in reducing wasteful spending than policies focusing solely on hospitals,” the authors wrote.

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Tsugawa Y, Jha AK, Newhouse JP, Zaslavsky AM, Jena AB. Variation in physician spending and association with patient outcomes [published online March 13, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.0059

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