FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W257697346> ?p ?o ?g. }

• W257697346 endingPage "13" @default.
• W257697346 startingPage "11" @default.
• W257697346 abstract "When my Dartmouth colleague Dr. John Wennberg drove through Vermont in the late 1960s collecting data on admissions, surgical procedures, and doctor visits, he found something unexpected--enormous variability in rates of medical care use across seemingly similar Vermont towns. In some school districts, nearly every school child still retained his tonsils, while in other districts, nearly every school child's tonsils had been removed. Since 1996, the Dartmouth Atlas of Healthcare has used national Medicare claims data to document regional variations in health care patterns, now across 306 hospital referral in the United States. The most recent data from 2010 shows per capita age-sex-race-price-adjusted Medicare expenditures ranging from $6,176 in LaCrosse, Wisconsin to $13,824 in McAllen, Texas. These variations have captured the attention of a now-expanding group of economists, physicians, and other social scientists. Both NBER and Dartmouth have been centers for this research, much of which has been supported with funding through the National Institute on Aging. My work, with various collaborators, has focused on three general questions: 1. What are the causes of regional variations in health care utilization? Health status is one leading candidate for the observed variations; after all, regions in Louisiana or West Virginia should spend more, given the greater burden of disease and poverty in those states. One study drew on rich survey data of elderly Medicare enrollees with information about income, poverty status, health behaviors such as smoking and drinking, and self-reported health, and found that health and income explained one-third of overall regional variations, leaving two-thirds unexplained. (1) A different approach compared treatment patterns for specific diseases such as heart attacks with highly detailed chart-review information; even this apples-to-apples approach finds considerable differences in risk-adjusted spending between the highest and lowest quintile of Medicare patients. (2) Another explanation for the regional variations is patient preferences and demand more generally - people in high-spending regions may demand, and get, more health care. We have tested this hypothesis using a national survey of Medicare enrollees, where enrollees were asked about their preferences for more intensive diagnoses and treatments. (3) However, we did not find that patient preferences in a region could explain more than a small fraction (generally less than 10 percent) of the overall regional variations in Medicare spending across regions. If not health or demand, then perhaps these variations are the consequence of demand: physicians prescribing more than medically necessary to augment their income. One problem with this explanation is that Medicare is a federally administered program that pays just about the same for procedures (adjusted for local prices) in LaCrosse, Wisconsin as in McAllen, Texas. If McAllen physicians are engaging in classic supply-induced demand behavior, then why aren't LaCrosse physicians? If not the standard supplier-induced demand story, then perhaps a more subtle version applies: that physicians perform clinically unnecessary proedures in response to peer pressure from referring physicians, or because patients insisted on them. We found that physicians were surprisingly disposed to reporting such effects, but these factors didn't explain regional differences in Medicare expenditures. Instead, physician beliefs in the effectiveness of intensive treatments for chronically ill patients (for example those with serious Class IV heart failure) were the best explanation for why some regions spent so much more than others. (4) That many of these beliefs were inconsistent with guidelines set by the American College of Cardiology, and the American Heart Association, at least points to the possibility that some treatments are being provided with very little benefit to patients. …" @default.
• W257697346 created "2016-06-24" @default.
• W257697346 creator A5091310966 @default.
• W257697346 date "2013-09-22" @default.
• W257697346 modified "2023-09-24" @default.
• W257697346 title "The Economics of Variations in Health and Health Care" @default.
• W257697346 cites W1488010464 @default.
• W257697346 cites W1591518484 @default.
• W257697346 cites W1905159967 @default.
• W257697346 cites W1967708568 @default.
• W257697346 cites W2101857176 @default.
• W257697346 cites W2129327240 @default.
• W257697346 cites W2151443489 @default.
• W257697346 cites W2891222456 @default.
• W257697346 cites W3121573081 @default.
• W257697346 cites W3122068553 @default.
• W257697346 cites W3123173804 @default.
• W257697346 cites W3123679862 @default.
• W257697346 cites W3123902523 @default.
• W257697346 hasPublicationYear "2013" @default.
• W257697346 type Work @default.
• W257697346 sameAs 257697346 @default.
• W257697346 citedByCount "0" @default.
• W257697346 crossrefType "journal-article" @default.
• W257697346 hasAuthorship W257697346A5091310966 @default.
• W257697346 hasConcept C127598652 @default.
• W257697346 hasConcept C144024400 @default.
• W257697346 hasConcept C149923435 @default.
• W257697346 hasConcept C160735492 @default.
• W257697346 hasConcept C162324750 @default.
• W257697346 hasConcept C189326681 @default.
• W257697346 hasConcept C205649164 @default.
• W257697346 hasConcept C2776135927 @default.
• W257697346 hasConcept C2776534028 @default.
• W257697346 hasConcept C2780128664 @default.
• W257697346 hasConcept C2908647359 @default.
• W257697346 hasConcept C50522688 @default.
• W257697346 hasConcept C512399662 @default.
• W257697346 hasConcept C71924100 @default.
• W257697346 hasConcept C74909509 @default.
• W257697346 hasConcept C99454951 @default.
• W257697346 hasConceptScore W257697346C127598652 @default.
• W257697346 hasConceptScore W257697346C144024400 @default.
• W257697346 hasConceptScore W257697346C149923435 @default.
• W257697346 hasConceptScore W257697346C160735492 @default.
• W257697346 hasConceptScore W257697346C162324750 @default.
• W257697346 hasConceptScore W257697346C189326681 @default.
• W257697346 hasConceptScore W257697346C205649164 @default.
• W257697346 hasConceptScore W257697346C2776135927 @default.
• W257697346 hasConceptScore W257697346C2776534028 @default.
• W257697346 hasConceptScore W257697346C2780128664 @default.
• W257697346 hasConceptScore W257697346C2908647359 @default.
• W257697346 hasConceptScore W257697346C50522688 @default.
• W257697346 hasConceptScore W257697346C512399662 @default.
• W257697346 hasConceptScore W257697346C71924100 @default.
• W257697346 hasConceptScore W257697346C74909509 @default.
• W257697346 hasConceptScore W257697346C99454951 @default.
• W257697346 hasIssue "3" @default.
• W257697346 hasLocation W2576973461 @default.
• W257697346 hasOpenAccess W257697346 @default.
• W257697346 hasPrimaryLocation W2576973461 @default.
• W257697346 hasRelatedWork W1536261411 @default.
• W257697346 hasRelatedWork W1593471813 @default.
• W257697346 hasRelatedWork W1752420448 @default.
• W257697346 hasRelatedWork W1905159967 @default.
• W257697346 hasRelatedWork W1969744056 @default.
• W257697346 hasRelatedWork W2060584931 @default.
• W257697346 hasRelatedWork W2066802368 @default.
• W257697346 hasRelatedWork W2068217268 @default.
• W257697346 hasRelatedWork W2084622559 @default.
• W257697346 hasRelatedWork W2128721843 @default.
• W257697346 hasRelatedWork W2149634726 @default.
• W257697346 hasRelatedWork W2189411758 @default.
• W257697346 hasRelatedWork W2254008380 @default.
• W257697346 hasRelatedWork W2292529700 @default.
• W257697346 hasRelatedWork W236611087 @default.
• W257697346 hasRelatedWork W2489250579 @default.
• W257697346 hasRelatedWork W2896808428 @default.
• W257697346 hasRelatedWork W3080643045 @default.
• W257697346 hasRelatedWork W3123437607 @default.
• W257697346 hasRelatedWork W2478750549 @default.
• W257697346 hasVolume "2013" @default.
• W257697346 isParatext "false" @default.
• W257697346 isRetracted "false" @default.
• W257697346 magId "257697346" @default.
• W257697346 workType "article" @default.