More Medical Care May Not Be Better Care

More medical care does not necessarily mean better care for Medicare patients, according to a new study published in the Annals of Internal Medicine.

Health care researchers know that patients are likelier to receive more care in some areas of the country than in others. In some regions, particularly those with more hospitals and specialists, patients see more specialists, are more likely to be hospitalized, and have more tests and minor procedures done. You might think that this extra care would result in a longer and better-quality life. Not so, according to the study, which found that Medicare patients being treated for serious conditions in the highest-spending regions showed no evidence of living longer or having higher levels of patient satisfaction than those treated in lower-cost areas.

In fact, Medicare enrollees in higher-spending areas were slightly less likely to get certain recommended follow-up care like aspirin for heart attack patients, the study found. The study''s lead researcher, Dr. Elliott S. Fisher, speculated that this may be because of confusion resulting from being treated by multiple specialists. "If there are five specialists involved in your care, each one is going to be slightly less likely to take responsibility for your care"--and more likely to think "another doctor has prescribed aspirin," said Fisher.

The study concludes that with more restraint on the part of physicians, "savings of up to 30 percent of Medicare spending might be possible." Although the researchers recommended caution in making cuts, Fisher said that "one of the things I hope comes out of our study is a willingness to question whether a more intensive practice or intervention is in our interests." .

To read an article on the study in the Los Angeles Times, click here. (Article may be only temporarily available.)

To read abstracts of the study in the Annals of Internal Medicine, click on https://www.annals.org/issues/v138n4/abs/200302180-00006.html and https://www.annals.org/issues/v138n4/abs/200302180-00007.html