Is Small-Area Variation in Healthcare Utilization Explained by Physician Financial Self-Interest?

The researchers explored the extent to which small-area variation (SAV) in health care utilization and expenditure is accounted for by physicians with a financial self-interest (FSI), particularly as it relates to imaging procedures. They investigated the variation/financial self-interest relationship: 1) for imaging modalities, including CT, MRI, interventional radiology, ultrasound, nuclear medicine, and radiography; 2) by examining total health costs; 3) by exploring the relation of FSI in coronary revascularization to the volume of cardiac-related procedures; and 4) by determining whether having FSI in both imaging and revascularization has a greater effect than each alone. The objective of the study was to determine whether FSI is one of the causes of utilization variation and whether FSI might be addressed to reduce health care costs without sacrificing quality or access.