Quality Supply of Medical Services

When is more less?

Do more intensive medical services improve patient satisfaction?  Not according to Mittler et al. (2010):

Overall, higher intensity use was associated (p<.05) with worse (seven measures) or no better care experiences (two measures).  In higher-intensity markets, Medicare FFS and MA beneficiaries reported more problems getting care quickly and less helpful office staff. However, Medicare FFS beneficiaries in higher-intensity markets reported higher overall ratings of their personal physician and main specialist. Medicare MA beneficiaries in higher-intensity markets also reported worse quality of communication with physicians, ability to get needed care, and overall ratings of care.

Medicare beneficiaries in markets characterized by high service use did not report better experiences with care. This trend was strongest for those in managed care.

More intensive medicine involves relatively more capital and less labor in the provision of  medical services.  If more labor inputs are correlated with higher patient satisfaction scores, areas with less intensive medical care may benefit in the rankings due to longer patient-physician interactions.  Whether or not the marginal value of an additional unit of capital compared to labor is most beneficial to health outcomes, however, has yet to be determined.

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