QUICK SEARCH:   [advanced]
Author:
Keyword(s):
Year:  Vol:  Page: 

   

 

Health Affairs, 27, no. 3 (2008): 813-823
doi: 10.1377/hlthaff.27.3.813
© 2008 by Project HOPE
 
New Online
 * House Health Reform Bill
 * Paying for Reform
 * Vetting AHIP's Report
 * HIV/AIDS Costs
 * Brief: Insurance Reform
 * HA Blog Top 10
This Article
* Figures Only
* Full Text (HTML)
* Reprint (PDF)
* Online Appendices
* Submit a response to this article
* Alert me when this article is cited
* Alert me when Comments are posted
* Alert me if a correction is posted
Services
* E-mail this article to a friend
* Similar articles in this journal
* Similar articles in PubMed
* Alert me to new issues of the journal
* Add to My Personal Archive
* Download to Citation Manager
*Reprints & Permissions
Citing Articles
* Citing Articles via HighWire
* Citing Articles via Google Scholar
Google Scholar
* Articles by Sirovich, B.
* Articles by Fisher, E. S.
* Search for Related Content
PubMed
* PubMed Citation
* Articles by Sirovich, B.
* Articles by Fisher, E. S.
Related Collections
* Physicians
* Quality Of Care
* Health Spending
* Consumer Issues
* Variations

Health Tracking

MARKETWATCH

Discretionary Decision Making By Primary Care Physicians And The Cost Of U.S. Health Care

Brenda Sirovich, Patricia M. Gallagher, David E. Wennberg and Elliott S. Fisher

Efforts to improve the quality and costs of U.S. health care have focused largely on fostering physician adherence to evidence-based guidelines, ignoring the role of clinical judgment in more discretionary settings. We surveyed primary care physicians to assess variability in discretionary decision making and evaluate its relationship to the cost of health care. Physicians in high-spending regions see patients back more frequently and are more likely to recommend screening tests of unproven benefit and discretionary interventions compared with physicians in low-spending regions; however, both appear equally likely to recommend guideline-supported interventions. Greater attention should be paid to the local factors that influence physicians’ clinical judgment in discretionary settings.


Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati    What's this?


This article has been cited by other articles:


Home page
ptjournalHome page
D. U. Jette, R. Brown, N. Collette, W. Friant, and L. Graves
Physical Therapists' Management of Patients in the Acute Care Setting: An Observational Study
Physical Therapy, November 1, 2009; 89(11): 1158 - 1181.
[Abstract] [Full Text] [PDF]


Home page
ANN INTERN MEDHome page
M. R. Gillick
Medicine as Ecoculture
Ann Intern Med, October 20, 2009; 151(8): 577 - 580.
[Abstract] [Full Text] [PDF]


Home page
BMJHome page
A. G Mulley
Inconvenient truths about supplier induced demand and unwarranted variation in medical practice
BMJ, October 20, 2009; 339(oct20_2): b4073 - b4073.
[Full Text]


Home page
NEJMHome page
J. M. Sutherland, E. S. Fisher, and J. S. Skinner
Getting Past Denial -- The High Cost of Health Care in the United States
N. Engl. J. Med., September 24, 2009; 361(13): 1227 - 1230.
[Full Text] [PDF]


Home page
Health Aff (Millwood)Home page
P. S. Hussey, M. E. Sorbero, A. Mehrotra, H. Liu, and C. L. Damberg
Episode-Based Performance Measurement And Payment: Making It A Reality
Health Aff., September 1, 2009; 28(5): 1406 - 1417.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
E. S. Fisher, J. P. Bynum, and J. S. Skinner
Slowing the Growth of Health Care Costs -- Lessons from Regional Variation
N. Engl. J. Med., February 26, 2009; 360(9): 849 - 852.
[Full Text] [PDF]


Home page
Health Aff (Millwood)Home page
R. A. Cooper
States With More Health Care Spending Have Better-Quality Health Care: Lessons About Medicare
Health Aff., January 1, 2009; 28(1): w103 - w115.
[Abstract] [Full Text] [PDF]


Home page
Health Aff (Millwood)Home page
J. Skinner, A. Chandra, D. Goodman, and E. S. Fisher
The Elusive Connection Between Health Care Spending And Quality
Health Aff., January 1, 2009; 28(1): w119 - w123.
[Abstract] [Full Text] [PDF]



Home | Current Issue | Archives | Topic Collections | Search | Blog | Subscribe | Contact Us | Help

© 2001-2008 Project HOPE–The People-to-People Organization
Terms and Policies