Medical News and Perspectives
July 12, 2006

Less May Be More When Managing Patients With Severe Chronic Illness

JAMA. 2006;296(2):159-160. doi:10.1001/jama.296.2.159

While conventional wisdom states that care for older patients with chronic diseases is best performed by specialty physicians in acute care settings such as academic medical centers, a new report suggests otherwise.

Researchers with the Center for the Evaluative Clinical Sciences at Dartmouth Medical School in Hanover, NH, reported that medical costs varied across the nation but that quality of care is not necessarily linked to higher-cost care. For more than a decade, these researchers have been studying and issuing reports showing such variation, but this study shows for the first time differences among specific hospitals and their physician networks. These differences in cost, visits to specialists, days in the hospital, and use of intensive care beds exist after controlling for illness severity.

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