• Corpus ID: 12354581

TWO Causes and Consequences of Regional Variations in Health Care 1

@inproceedings{Skinner2011TWOCA,
  title={TWO Causes and Consequences of Regional Variations in Health Care 1},
  author={Jonathan Skinner},
  year={2011}
}
There are widespread differences in health care spending and utilization across regions of the US as well as in other countries. Are these variations caused by demand-side factors such as patient preferences, health status, income, or access? Or are they caused by supply-side factors such as provider financial incentives, beliefs, ability, or practice norms? In this chapter, I first consider regional health care differences in the context of a simple demand and supply model, and then focus on… 
1 Citations

Figures and Tables from this paper

Geographic and Age-Based Variations in Medicare Reimbursement Among ASSH Members
TLDR
Investigation of how American Society for Surgery of the Hand members’ Medicare reimbursement depends on their geographical location and number of years in practice found Peak reimbursement from Medicare for ASSH members appears to be related to the time of surgeons’ peak operative volume, rather than any age-based bias for or against treating Medicare beneficiaries.

References

SHOWING 1-10 OF 172 REFERENCES
Geographic Variation in Health Care: The Role of Private Markets
TLDR
It is argued that private insurers have stronger incentives to restrain utilization and costs, while public insurers have greater monopsony power to restrain prices, should lead to greater regional variation in utilization for the public sector, but either more or less variation in spending.
An analysis of the regional differences in health care utilization in Italy.
Small Area Variations in Health Care Delivery
TLDR
Numbers show prima facie inequalities in the input of resources that are associated with income transfer from areas of lower expenditure to areas of higher expenditure, which indicates that there is considerable uncertainty about the effectiveness of different levels of aggregate, as well as specific kinds of, health services.
The Implications of Regional Variations in Medicare Spending. Part 2: Health Outcomes and Satisfaction with Care
TLDR
The researchers examined costs and outcomes of care for hip fracture, colorectal cancer, and acute myocardial infarction using end-of-life care spending as an indicator of Medicare spending and carried out a cohort study in four parallel populations using a natural randomization approach.
The Efficiency of Medicare
TLDR
It is found that a large component of Medicare expenditures appears to provide no benefit in terms of survival, nor is it likely that this extra spending improves the quality of life.
Variation in the tendency of primary care physicians to intervene.
TLDR
Varying rates of health care spending across the United States reflect the underlying tendency of local physicians to recommend interventions for their patients, and findings that physicians in high-spending regions have a greater tendency to intervene persisted in analyses stratified by physician specialty.
The Geography of Medicare
TLDR
It is found that a substantial amount of variation can be explained by differences across areas in the health of the elderly population, which suggests that some of the geographic variation in Medicare spending is efficient.
The Implications of Regional Variations in Medicare Spending. Part 1: The Content, Quality, and Accessibility of Care
TLDR
A cohort study in four parallel cohorts using end-of-life care spending as an indicator of Medicare spending and examined costs and outcomes of care for hip fracture, colorectal cancer, and acute myocardial infarction to determine whether the increased spending in high-cost regions results in better care or improved health.
Productivity Spillovers in Health Care: Evidence from the Treatment of Heart Attacks
TLDR
Using data on treatments for heart attacks, a simple Roy model of patient treatment choice with productivity spillovers is developed that predicts that high‐use areas will have higher returns to surgery, better outcomes among patients most appropriate for surgery, and worse outcomes among Patients leastappropriate for surgery while displaying no relationship between treatment intensity and overall outcomes.
Are Regional Variations in End-of-Life Care Intensity Explained by Patient Preferences?: A Study of the US Medicare Population
TLDR
Medicare beneficiaries generally prefer treatment focused on palliation rather than life-extension, and differences in preferences are unlikely to explain regional variations in EOL spending.
...
...