Regional medical practice variation in high-cost healthcare services: Evidence from diagnostic imaging in Austria

Berger, Michael and Czypionka, ThomasORCID: https://orcid.org/0000-0002-3381-1075 (2021) Regional medical practice variation in high-cost healthcare services: Evidence from diagnostic imaging in Austria. The European Journal of Health Economics, pp. 1-13. (Published before print)

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Abstract or Table of Contents

Magnetic resonance imaging (MRI) is a popular yet cost-intensive diagnostic measure whose strengths compared to other medical imaging technologies have led to increased application. But the benefits of aggressive testing are doubtful. The comparatively high MRI usage in Austria in combination with substantial regional variation has hence become a concern for its policy makers. We use a set of routine healthcare data on outpatient MRI service consumption of Austrian patients between Q3-2015 and Q2-2016 on the district level to investigate the extent of medical practice variation in a two-step statistical analysis combining multivariate regression models and Blinder–Oaxaca decomposition. District-level MRI exam rates per 1.000 inhabitants range from 52.38 to 128.69. Controlling for a set of regional characteristics in a multivariate regression model, we identify payer autonomy in regulating access to MRI scans as the biggest contributor to regional variation. Nevertheless, the statistical decomposition highlights that more than 70% of the regional variation remains unexplained by differences between the observable district characteristics. In the absence of epidemiological explanations, the substantial regional medical practice variation calls the efficiency of resource deployment into question.

Item Type: Article in Academic Journal
Keywords: Healthcare service utilization; Magnetic resonance imaging; Medical practice variation; Health policy; Blinder–Oaxaca decomposition
Classification Codes (e.g. JEL): C33; H510; I18
Research Units: Health Economics and Health Policy
Status: Published before print
Date Deposited: 19 Apr 2021 08:18
Last Modified: 19 Apr 2021 08:18
Identification Number or DOI: 10.1007/s10198-021-01298-w
ISSN: 1618-7598
URI: https://irihs.ihs.ac.at/id/eprint/5805

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