title: Physician practice size and variations in treatments and outcomes: evidence from Medicare patients with AMI.
abstract: Little is known about the relationships between physician practice size and patient treatments or outcomes. We examined whether the practice size of attending physicians was related to within-hospital differences in care for Medicare patients with acute myocardial infarction (AMI). We found that patients treated by solo physicians were less likely to receive cardiac catheterization and angioplasty within a day of admission and more likely to die than other patients in the same hospital, even after a number of patient and physician characteristics were taken into account. These differences suggest that solo practitioners are less likely to follow guidelines calling for quick use of angioplasty.
authors.affiliation: School of Health Management and Policy, W.P. Carey School of Business, Arizona State University, Tempe, USA. ketcham@asu.edu
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Ketcham
authors.forename: Laurence C
authors.initials: LC
authors.lastname: Baker
authors.forename: Donna
authors.initials: D
authors.lastname: MacIsaac
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D018588:Fee-for-Service Plans; D005260:Female; D006123:Group Practice / Q000592:standards; D006801:Humans; D016015:Logistic Models; D008297:Male; D008505:Medical Staff, Hospital / Q000458:organization & administration / Q000592:standards*; D006278:Medicare / Q000592:standards*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D011216:Practice Management, Medical / Q000145:classification* / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011331:Private Practice / Q000592:standards; D014481:United States / Q000453:epidemiology