Abstract
BACKGROUND - The authors of previous studies have suggested that family physicians generate lower health care expenditures than internists. Explanations for this difference have not been explored. METHODS - We surveyed 61 family physicians and 112 internists within a managed care organization regarding their demographic, practice, and psychological characteristics. We derived physician costs per enrollee and case-mix adjustment using claims data. RESULTS - In a multivariate analysis, we found that family physicians were significantly less risk averse than general internists. After adjustment for case mix, family physicians generated 5% lower costs (95% confidence interval [CI], 2% - 9%). After adjustment for case mix, risk-averse physicians generated higher expenditures; a one standard deviation increase in risk-aversion was associated with a 3% increase in expenditures (95% CI, 1% - 5%). After adjustment for case mix and risk aversion, family physicians' costs were no longer significantly lower (3%; 95% CI, -1% to 7%). None of the other physician demographic, practice, or psychological characteristics were significantly associated with case-mix- adjusted expenditures. CONCLUSIONS - The lower costs per patient generated by family physicians compared with internists may reflect psychological differences in risk aversion.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 12-17+18 |
| Journal | Journal of Family Practice |
| Volume | 49 |
| Issue number | 1 |
| State | Published - Jan 2000 |
| Externally published | Yes |
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Keywords
- Attitude
- Physician's practice
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
Cite this
Risk aversion and costs : A comparison of family physicians and general internists. / Fiscella, Kevin; Franks, Peter; Zwanziger, Jack; Mooney, Cathleen; Sorbero, Melony; Williams, Geoffrey C.
In: Journal of Family Practice, Vol. 49, No. 1, 01.2000, p. 12-17+18.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk aversion and costs
T2 - A comparison of family physicians and general internists
AU - Fiscella, Kevin
AU - Franks, Peter
AU - Zwanziger, Jack
AU - Mooney, Cathleen
AU - Sorbero, Melony
AU - Williams, Geoffrey C.
PY - 2000/1
Y1 - 2000/1
N2 - BACKGROUND - The authors of previous studies have suggested that family physicians generate lower health care expenditures than internists. Explanations for this difference have not been explored. METHODS - We surveyed 61 family physicians and 112 internists within a managed care organization regarding their demographic, practice, and psychological characteristics. We derived physician costs per enrollee and case-mix adjustment using claims data. RESULTS - In a multivariate analysis, we found that family physicians were significantly less risk averse than general internists. After adjustment for case mix, family physicians generated 5% lower costs (95% confidence interval [CI], 2% - 9%). After adjustment for case mix, risk-averse physicians generated higher expenditures; a one standard deviation increase in risk-aversion was associated with a 3% increase in expenditures (95% CI, 1% - 5%). After adjustment for case mix and risk aversion, family physicians' costs were no longer significantly lower (3%; 95% CI, -1% to 7%). None of the other physician demographic, practice, or psychological characteristics were significantly associated with case-mix- adjusted expenditures. CONCLUSIONS - The lower costs per patient generated by family physicians compared with internists may reflect psychological differences in risk aversion.
AB - BACKGROUND - The authors of previous studies have suggested that family physicians generate lower health care expenditures than internists. Explanations for this difference have not been explored. METHODS - We surveyed 61 family physicians and 112 internists within a managed care organization regarding their demographic, practice, and psychological characteristics. We derived physician costs per enrollee and case-mix adjustment using claims data. RESULTS - In a multivariate analysis, we found that family physicians were significantly less risk averse than general internists. After adjustment for case mix, family physicians generated 5% lower costs (95% confidence interval [CI], 2% - 9%). After adjustment for case mix, risk-averse physicians generated higher expenditures; a one standard deviation increase in risk-aversion was associated with a 3% increase in expenditures (95% CI, 1% - 5%). After adjustment for case mix and risk aversion, family physicians' costs were no longer significantly lower (3%; 95% CI, -1% to 7%). None of the other physician demographic, practice, or psychological characteristics were significantly associated with case-mix- adjusted expenditures. CONCLUSIONS - The lower costs per patient generated by family physicians compared with internists may reflect psychological differences in risk aversion.
KW - Attitude
KW - Physician's practice
UR - http://www.scopus.com/inward/record.url?scp=0342647495&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0342647495&partnerID=8YFLogxK
M3 - Article
C2 - 10691394
AN - SCOPUS:0342647495
VL - 49
SP - 12-17+18
JO - Journal of Family Practice
JF - Journal of Family Practice
SN - 0094-3509
IS - 1
ER -