Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending

David Cutler, Jonathan S. Skinner, Ariel Dora Stern and David Wennberg

American Economic Journal: Economic Policy, 2019, vol. 11, issue 1, 192-221

Abstract: There is considerable controversy about the causes of regional variations in health care expenditures. Using vignettes from patient and physician surveys linked to fee-for-service Medicare expenditures, this study asks whether patient demand-side factors or physician supply-side factors explain these variations. The results indicate that patient demand is relatively unimportant in explaining variations. Physician organizational factors matter, but the most important factor is physician beliefs about treatment. In Medicare, we estimate that 35 percent of spending for end-of-life care and 12 percent of spending for heart attack patients (and for all enrollees) is associated with physician beliefs unsupported by clinical evidence.

JEL-codes: D83 H75 I11 I18 (search for similar items in EconPapers)
Date: 2019
Note: DOI: 10.1257/pol.20150421
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Citations: View citations in EconPapers (96)

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