Risk aversion and costs

A comparison of family physicians and general internists

Kevin Fiscella, Peter Franks, Jack Zwanziger, Cathleen Mooney, Melony Sorbero, Geoffrey C. Williams

Research output: Contribution to journalArticle

46 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)12-17+18
JournalJournal of Family Practice
Volume49
Issue number1
StatePublished - Jan 2000
Externally publishedYes

Fingerprint

Family Physicians
Risk Adjustment
Health Expenditures
Costs and Cost Analysis
Confidence Intervals
Psychology
Physicians
Demography
Diagnosis-Related Groups
Managed Care Programs
Multivariate Analysis
Organizations
Delivery of Health Care

Keywords

  • Attitude
  • Physician's practice

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Fiscella, K., Franks, P., Zwanziger, J., Mooney, C., Sorbero, M., & Williams, G. C. (2000). Risk aversion and costs: A comparison of family physicians and general internists. Journal of Family Practice, 49(1), 12-17+18.

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 journalArticle

Fiscella, K, Franks, P, Zwanziger, J, Mooney, C, Sorbero, M & Williams, GC 2000, 'Risk aversion and costs: A comparison of family physicians and general internists', Journal of Family Practice, vol. 49, no. 1, pp. 12-17+18.
Fiscella K, Franks P, Zwanziger J, Mooney C, Sorbero M, Williams GC. Risk aversion and costs: A comparison of family physicians and general internists. Journal of Family Practice. 2000 Jan;49(1):12-17+18.
Fiscella, Kevin ; Franks, Peter ; Zwanziger, Jack ; Mooney, Cathleen ; Sorbero, Melony ; Williams, Geoffrey C. / Risk aversion and costs : A comparison of family physicians and general internists. In: Journal of Family Practice. 2000 ; Vol. 49, No. 1. pp. 12-17+18.
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