The amount spent by hospitalists can vary from doctor to doctor within the same facility, but those that spend more on tests and treatments may not see better patient outcomes, according to a new study.
Researchers at Harvard Medical School examined a random 20% sample of nationally representative data on Medicare patients—including about 500,000 hospitalizations treated by 20,000 hospitalists at 3,000 U.S. hospitals. They found that 8.4% of variation in healthcare spending could be explained by differences between doctors. About 7% could be explained by differences in hospitals.
What’s more, the physicians that spent more did not see fewer readmissions or have lower mortality rates than those that spent less, according to the study, which was published in JAMA Internal Medicine.
"If you spend more money on a car or a TV, you tend to get a nicer car or a better TV," Anupam B. Jena, M.D., a professor of health policy at Harvard and the study’s senior author, said in an announcement. "Our findings show that's not the case when it comes to medical care. Spending more doesn't always mean you get better health."
Within the same hospital, the hospitalists in the top quartile of spending spent 40% more than those in the lowest quartile when treating the same patients, according to the study. Yusuke Tsugawa, M.D., the study’s lead author and a research associate at the Harvard T.H. Chan School of Public Health, said the findings suggest that the industry should look at individual doctors’ spending in addition to hospitals’ when looking to improve the value of care.
Though Jena cautioned that the results don’t necessarily mean that the highest-spending doctors should simply spend less to achieve the same results.
"Say you have two painters. One usually takes two hours to paint a room, and one takes six hours. You can ask the slow painter to hurry up, but you might end up with a room that's sloppily painted, or with one of the walls the wrong color," Jena said in the announcement. "That's obviously a situation we want to avoid in health care."