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Related Experiment Videos

Practice variation and physician-specific effects.

Jostein Grytten1, Rune Sørensen

  • 1Dental Faculty, University of Oslo, P.O. Box 1052, Blindern, 0316 Oslo, Norway. josteing@odont.uio.no

Journal of Health Economics
|April 10, 2003
PubMed
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Physician practice style significantly impacts healthcare spending, explaining most cost variations in primary care services. Patient factors like age and gender have minimal influence on these expenditures.

Area of Science:

  • Health Services Research
  • Medical Economics
  • Clinical Practice Variation

Background:

  • Previous research on practice variation primarily focused on specialist and hospital services.
  • Limited data exists on treatment variation within primary physician services.
  • Understanding practice variation is crucial for healthcare expenditure management.

Purpose of the Study:

  • To estimate practice variation in primary physician services in Norway.
  • To identify determinants of expenditure variation in primary care.
  • To assess the stability of physician practice styles.

Main Methods:

  • Analysis of a large dataset from individual physician practices.
  • Estimation of practice variation based on diagnosis and treatment type.

Related Experiment Videos

  • Examination of practice style changes after physicians relocated.

    • Main Results:

    • Physician-specific practice variation explained 47-66% of expenditure for laboratory tests, 59-66% for long consultations, and 49-61% for procedures.
    • Patient age and gender accounted for only ~1% of expenditure variation, confirming their inadequacy as risk adjusters.
    • Physicians maintained consistent practice styles even after relocating, indicating deeply rooted behavioral patterns.

    Conclusions:

    • Clinical practice variation among physicians is a major driver of primary care costs.
    • Physician practice style is stable and deeply ingrained, independent of patient populations.
    • Healthcare policy should consider physician practice behavior when addressing cost variations.