Costly Doctors Don’t Provide Better Care

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Doctors who tend to spend more in treating hospitalized patients do not get better results than those who spend less, a new study has found.

Researchers examined spending records of 72,042 physicians at more than 3,000 acute care hospitals. The patients were fee-for-service Medicare beneficiaries 65 and older treated between January 2011 and the end of 2014.

The investigators calculated spending in the first two years, and tracked outcomes in the last two. They concentrated on the types of spending controlled by doctor choice — tests, procedures, imaging studies and so on. The study is in JAMA Internal Medicine.

After adjusting for the varying characteristics of the hospitals, they found that spending among physicians varied by as much as 10.5 percent.

But there was no association over all between higher physician spending and 30-day mortality, or between spending and readmissions. In other words, more spending did not yield better results.

“Even when you go to the same hospital, you’re going to get a different bill — as much as 40 percent higher — depending on who treats you,” said the lead author, Dr. Yusuke Tsugawa, a researcher at the Harvard T.H. Chan School of Public Health. “And you’re not getting better care from a doctor who submits a higher bill.”