Table 1—
Primary Variables and Sample Distribution
| Variable | Mean | Individual standard deviation | Area average standard deviation | p-value |
|---|---|---|---|---|
| Panel A. Spending and utilization | ||||
| Two-year end-of-life spending | $55,194 | — | $10,634 | — |
| Average EOL spending | $14,409 | — | $3,983 | — |
| Hip fracture patient spending | $52,282 | — | $4,882 | — |
| Panel B. Patient variables (N = 1,516) | ||||
| Have unneeded tests | 73% | 45% | 11% | <0.01 |
| See unneeded cardiologist | 56% | 50% | 14% | <0.01 |
| Aggressive patient preferences ratio | 8.0% | 27% | 7.0% | <0.01 |
| Comfort patient preferences ratio | 48% | 50% | 13% | <0.01 |
| Panel C. Primary care physician variables (N = 570 in restricted sample) | ||||
| Cowboy | 23% | 42% | 27% | <0.01 |
| Comforter | 44% | 50% | 28% | <0.01 |
| Follow-up low | 8.8% | 28% | 19% | <0.01 |
| Follow-up high | 4.4% | 20% | 6.4% | <0.01 |
| Panel D. Cardiologist variables (N = 415 in restricted sample) | ||||
| Cowboy | 26% | 44% | 20% | <0.01 |
| Comforter | 27% | 45% | 23% | <0.01 |
| Follow-up low | 1.4% | 12% | 6.3% | — |
| Follow-up high | 21% | 41% | 22% | <0.01 |
| Panel E. All physicians (N = 985 in restricted sample) | ||||
| Cowboy | 24% | 43% | 15% | <0.01 |
| Comforter | 37% | 48% | 18% | <0.01 |
| Follow-up low | 5.7% | 23% | 8.6% | <0.01 |
| Follow-up high | 12% | 32% | 12% | <0.01 |
| Panel F. Organizational and financial variables | ||||
| Reimbursement | ||||
| Fraction Medicare patients | 42% | 22% | — | — |
| Fraction Medicaid patients | 10% | 13% | — | — |
| Fraction capitated patients | 15% | 25% | — | — |
| Organizational factors | ||||
| Solo or two-person practice | 29% | 46% | — | — |
| Single/multi speciality group practice | 57% | 50% | — | — |
| Group/staff HMO or hospital-based practice | 13% | 33% | — | — |
| General controls | ||||
| Physician age | 53 | 10 | — | — |
| Male | 81% | 39% | — | — |
| Board certified | 88% | 33% | — | — |
| Weekly patient days | 2.9 | 1.5 | — | — |
| Cardiologists per 100k (N = 74, HRR-level) | 6.8 | 1.9 | — | — |
| Responsiveness factors | ||||
| Responds to referrer expectations (cardiologists only) | 31% | 46% | — | — |
| Responds to colleague expectations | 38% | 49% | — | — |
| Responds to patient expectations | 54% | 50% | — | — |
| Responds to malpractice concerns | 39% | 49% | — | — |
| Responds to practice financial incentives | 9% | 29% | — | — |
Notes: The table shows means for the (restricted) primary analysis sample. The p-value in the last column is for the null hypothesis of no excess variance across areas and is taken from a bootstrap of patient or physician responses across areas. For each of 1,000 simulations, we draw patients or providers randomly (with replacement) and calculate the simulated area average and the standard deviation of that area average. The empirical distribution of the standard deviation of the area average is used to form the p-value for the actual area average.