Exhibit 181 · Peer-reviewed cohort study
The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care
Medicare enrollees in higher-spending regions receive more care than those in lower-spending regions but do not have better health outcomes or satisfaction with care.
Same cohorts as Part 1 (hip fracture 614,503; colorectal cancer 195,429; acute myocardial infarction 159,393; survey sample 18,190). Each 10 percent increase in regional end-of-life spending was associated with a five-year relative risk of death of 1.003 (hip fracture), 1.012 (colorectal cancer, CI 1.004–1.019), 1.007 (myocardial infarction, CI 1.001–1.014) and 1.01 (survey sample). Functional decline and satisfaction did not differ consistently. Higher-spending regions did not have better outcomes or satisfaction.
- Source
- Fisher et al., Annals of Internal Medicine 138(4):288–298
- Date
- 18 February 2003
- Quoted from
- Abstract, Conclusions (Ann Intern Med 138(4):288-298)
- Grade
- Peer-reviewed
- Document
- https://doi.org/10.7326/0003-4819-138-4-200302180-00007
- Accessed
- 2026-11-09
- Cited by
- Findings citing this exhibit