Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending
利用患者和医生调查数据，结合按服务收费的Medicare支出，发现医生信念是解释医疗支出地区差异的最重要因素，而患者需求影响较小。
There is considerable controversy about the causes of regional variations in health care expenditures. Using vignettes from patient and physician surveys linked to fee-for-service Medicare expenditures, this study asks whether patient demand-side factors or physician supply-side factors explain these variations. The results indicate that patient demand is relatively unimportant in explaining variations. Physician organizational factors matter, but the most important factor is physician beliefs about treatment. In Medicare, we estimate that 35 percent of spending for end-of-life care and 12 percent of spending for heart attack patients (and for all enrollees) is associated with physician beliefs unsupported by clinical evidence..