Adjusted Patient Expenditures and Hospitalizations for Primary Care Physicians
| Expenditures (natural log) | ||||||
|---|---|---|---|---|---|---|
| All Primary Care Physicians | Family Physicians | General Internists | ||||
| β (95% CI) | P Value | β (95% CI) | P Value | β (95% CI) | P Value | |
| Training HSA spending categorya | ||||||
| Low | Reference | Reference | Reference | |||
| Average | 0.02 (−0.02 to 0.06) | .27 | 0.03 (−0.03 to 0.09) | .32 | 0.01 (−0.05 to 0.07) | .71 |
| High | 0.11 (0.06–0.15) | <.001 | 0.11 (0.05–0.17) | <.001 | 0.10 (0.04–0.16) | <.001 |
| Practice HSA spending category | ||||||
| Low ($6,102 to $8,683) | Reference | Reference | Reference | |||
| Average ($8,691 to $9,879) | 0.05 (0.01–0.09) | .02 | 0.03 (−0.03 to 0.09) | .26 | 0.07 (0.01–0.14) | .02 |
| High ($9,880 to $16,542) | 0.08 (0.04–0.13) | <.001 | 0.07 (0.01–0.13) | .03 | 0.11 (0.05–0.17) | <.001 |
| Number of physicians | 3,075 | 1,398 | 1,677 | |||
| Number of beneficiaries | 502,920 | 268,595 | 234,325 | |||
| Hospitalization (yes = 1, no = 0) | ||||||
|---|---|---|---|---|---|---|
| All PC Physicians | Family Physicians | General Internists | ||||
| OR (95% CI) | P Value | OR (95% CI) | P Value | OR (95% CI) | P Value | |
| Training HSA spending categorya | ||||||
| Low | Reference | Reference | Reference | |||
| Average | 1.05 (0.99–1.12) | .11 | 1.04 (0.96–1.13) | .34 | 1.04 (0.94–1.15) | .46 |
| High | 0.97 (0.90–1.04) | .36 | 1.00 (0.91–1.11) | .94 | 0.93 (0.84–1.03) | .18 |
| Practice HSA spending category | ||||||
| Low ($6,102 to $8,683) | Reference | Reference | Reference | |||
| Average ($8,691 to $9,879) | 1.00 (0.93–1.08) | .94 | 1.03 (0.94–1.13) | .51 | 0.98 (0.87–1.11) | .80 |
| High ($9,880 to $16,542) | 1.03 (0.95–1.11) | .49 | 1.09 (0.99–1.19) | .07 | 0.99 (0.88–1.10) | .82 |
| Number of physicians | 3,075 | 1,398 | 1,677 | |||
| Number of beneficiaries | 502,920 | 268,595 | 234,325 | |||
HSA = Hospital Service Area
Note: Data are based on 2011 Medicare Claims. Data are weighted and restricted to primary care physicians with 1–19 years of practice and 40 or more Medicare patients, excluding patients with total expenditures greater than $100,000.
↵a To standardize training HSA spending, we calculated a standardized z score for HSA spending for each year between 1992 and 2010. The training HSA spending groups are Low: −1.49 to −0.14; Average: −0.13 to 0.46; High: 0.48 – 4.50. Each group has approximately the same number of beneficiaries.