Elliot Fisher, MD, MPH
Professor of Medicine and of Community and Family Medicine, Co-Director VA Outcomes Group, Dartmouth Medical School

Spending and Quality: Is more really worse? Why might this be?

January 23, 2004
12:00 - 1:30 PM

Colonial Penn Center Auditorium



Dr. Fisher is also a general internist at the Department of Veterans Affairs Medical Center in White River Junction, Vermont where he co-directs the VA Outcomes Group, a research and training program for physicians. His research interests lie in three areas. First, he has worked to clarify the limitations of administrative databases and develop methods to overcome them. Second, he has developed approaches to resource allocation based upon the principles of benchmarking, first as a means of addressing inequities in the levels of hospital resources across communities in Oregon and more recently as applied to the U.S. physician supply. Most recently, he has focused on the health implications of the uneven distribution of health care resources. His current research, funded by the Robert Wood Johnson Foundation, examines the potential adverse consequences of increasing capacity in health care.

Two fold differences in per-capita Medicare spending are observed across U.S. regions that are independent of both local medical prices or underlying illness levels. Recent studies indicate that regions with a less conservative (and thus higher cost) practice pattern provide lower quality care and achieve worse health outcomes for Medicare enrollees. The presentation will examine evidence on the causes of these differences in spending and quality -- and the implications for policy and practice.

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The Leonard Davis Institute of Health Economics.
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