Appendix to Chapter 4

TABLE A4.1. Doctors’ Reported Knowledge of Regional Variation in Health Care Spending Studies

Familiarity with studies about geographic variation in health care spending (0–4)

Female (1=yes)

−0.029

[0.164]

Region=West

−0.109

[0.187]

Region=Northeast

−0.073

[0.200]

Region=Midwest

−0.019

[0.212]

Political interest (0=hardly at all; 3=most of the time)

0.337

[0.084]**

Respondent PID (-3=Str. Dem; 0=Ind.; 3=Str. Rep.)

−0.01

[0.039]

Years in practice

0.014

[0.007]*

Residency take place at VA? (1=yes)

0.321

[0.147]*

Practice affiliated w/academic med center (1=yes)

0.241

[0.166]

Respondent specialty=Medical specialty

−0.187

[0.181]

Respondent specialty=Surgical care

0.103

[0.187]

Income source=Salary plus bonus

0.146

[0.202]

Income source=Billing only

0.112

[0.211]

Income source=Other (including shift work or wages)

0.673

[0.315]*

Practice Type=Office based (specialty group)

0.216

[0.378]

Practice Type=Hospital based

0.216

[0.180]

Practice Type=Other (including group or staff model HMO)

0.242

[0.211]

Constant

−0.355

[0.321]

Observations

324

R-squared

0.109

Mean of Dependent Variable

1.174

Note: OLS regression coefficients with robust standard errors in brackets. Dependent variable: 0=have not heard anything about studies; 1=not at all familiar; 2=only a bit familiar; 3=somewhat familiar; 4=very familiar. Omitted reference categories: Region=South; Respondent specialty=Primary Care; Income Source=Salary; Practice Type=Office based (solo or two-person). * significant at 5%; ** significant at 1%

Source: Fall 2015 survey of physicians.

TABLE A4.2. Doctors’ Reported Reasons for Regional Variation in Health Care Spending

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Note: OLS regression coefficients with robust standard errors in brackets. Dependent variable: 1=item contributes “a lot”; 0=all other responses. Results are statistically and substantively similar when estimated using logistic regression. Omitted reference categories: Region=South; Respondent specialty=Primary Care; Income Source=Salary; Practice Type=Office based (solo or two-person).* significant at 5%; ** significant at 1%

Source: Fall 2015 survey of physicians.

TABLE A4.3. Beliefs about the Causes of Regional Variation in Medicare Spending Predicts Doctors’ Beliefs about the Importance of Various Goals to Medical Societies

Protecting clinical autonomy (1=not that important; 4=extremely important)

Identifying physicians not following best practices and bringing to board (1=not that important; 4=extremely important

Overuse of services of low or unproven value (1=none; 4=a lot)

0.028

[0.076]

0.198

[0.084]*

Health status and medical needs of Medicare patients (1=none; 4=a lot)

0.144

[0.060]*

0.036

[0.082]

Physicians’ beliefs in the value of certain treatments (1=none; 4=a lot)

0.151

[0.066]*

−0.072

[0.091]

How much Medicare pays physicians (1=none; 4=a lot)

0.083

[0.068]

0.124

[0.071]

Amount of care demanded by patients with the same condition (1=none; 4=a lot)

0.007

[0.079]

−0.041

[0.095]

Availability of expensive medical technologies (1=none; 4=a lot)

−0.073

[0.074]

0.207

[0.087]*

Threat of malpractice litigation is higher (1=none; 4=a lot)

0.106

[0.084]

0.026

[0.085]

Underuse of services of high or proven value (1=none; 4=a lot)

0

[0.084]

0.163

[0.092]

Female (1=yes)

0.118

[0.112]

−0.054

[0.133]

Region=West

−0.128

[0.119]

−0.021

[0.156]

Region=Northeast

−0.16

[0.113]

−0.053

[0.167]

Region=Midwest

−0.236

[0.140]

0.022

[0.159]

Political interest (0=hardly at all; 3=most of the time)

0.107

[0.062]

−0.026

[0.080]

Respondent PID (-3=Str. Dem; 0=Ind.; 3=Str. Rep.)

0.087

[0.027]**

0.018

[0.032]

Years in practice

−0.014

[0.005]**

−0.005

[0.006]

Residency take place at VA? (1=yes)

−0.005

[0.093]

−0.109

[0.116]

Practice affiliated w/academic med center (1=yes)

−0.107

[0.107]

0.024

[0.124]

Respondent specialty=Medical specialty

−0.048

[0.112]

0.253

[0.147]

Respondent specialty=Surgical care

−0.24

[0.120]*

−0.088

[0.163]

Income source=Salary plus bonus

−0.063

[0.123]

0.099

[0.160]

Income source=Billing only

−0.005

[0.125]

−0.096

[0.171]

Income source=Other (including shift work or wages)

−0.116

[0.232]

−0.092

[0.254]

Practice Type=Office based (specialty group)

0.026

[0.206]

−0.343

[0.321]

Practice Type=Hospital based

−0.015

[0.116]

−0.031

[0.151]

Practice Type=Other (including group or staff model HMO

−0.181

[0.141]

−0.006

[0.164]

Constant

2.16

[0.455]**

0.628

[0.579]

Observations

315

312

R-squared

0.165

0.127

Mean

3.177

2.397

Note: OLS regression coefficients with robust standard errors in brackets. Dependent variable: 1=not that important; 2=moderately important; 3=very important; 4=extremely important goal. Omitted reference categories: Region=South; Respondent specialty=Primary Care; Income Source=Salary; Practice Type=Office based (solo or two-person). * significant at 5%; ** significant at 1%

Source: Fall 2015 survey of physicians.

TABLE A4.4. Doctors’ Beliefs about the Importance of Various Goals to Medical Societies

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Note: OLS regression coefficients with robust standard errors in brackets. Dependent variable: 1=very/extremely important goal; 0=not that/moderately important goal. Results are statistically and substantively similar when estimated using logistic regression. Omitted reference categories: Region=South; Respondent specialty=Primary Care; Income Source=Salary; Practice Type=Office based (solo or two-person). * significant at 5%; ** significant at 1%

Source: Fall 2015 survey of physicians.

TABLE A4.5. What Should Medical Societies Do When a Medical Journal Publishes a Study That Calls into Question a Treatment?

Image

Note: OLS regression coefficients with robust standard errors in brackets. Dependent variable: 1=support (somewhat or strongly); 0=oppose (somewhat or strongly) or neither oppose nor support. Results are statistically and substantively similar when estimated using logistic regression. Omitted reference categories: Region=South; Respondent specialty=Primary Care; Income Source=Salary; Practice Type=Office based (solo or two-person). * significant at 5%; ** significant at 1%

Source: Fall 2015 survey of physicians.

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