More care is not always better care

While I had my own journal article published this week, my good friend and mentor Jack Fowler had an important paper, "Relationship Between Regional Per Capita Medicare Expenditures and Patient Perceptions of Quality of Care," published in JAMA.

A blog on boston.com summarized the paper as follows:

More isn't necessarily better when it comes to medical care, a survey of Medicare patients shows.

Spending on healthcare varies widely across the United States, from $12,000 a year for Miami beneficiaries to $5,700 for comparable care in Minneapolis, previous studies have shown. But research led by Floyd J. Fowler of the University of Massachusetts-Boston shows that money spent on medical care didn't necessarily match perceptions of the quality of that care.

More than 2,000 Medicare patients around the country were asked by phone and mailed questionnaire whether their needs were met, what they thought about the quality of their care as outpatients, and how they would rate their overall medical care.

People living in high-expenditure areas got more medical care than those living in lower-cost areas, judged by such measures as physician visits and cardiac tests. But when asked how they felt about their treatment, more patients living in lower-expenditure areas gave their quality of care top marks (9 or 10 on a scale of 0 to 10) than their peers in the high-priced parts of the country, by a margin of 63.3 percent compared to 55.4 percent.

"The results taken together document that spending more on medical care does not improve patient's perceptions of the medical care they receive," the authors write.