Abstract
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.
Highlights
In their quest to align healthcare expenditure with actual revenues, policy makers can find viable options in the reduction of wasteful spending
By applying the Blinder–Oaxaca decomposition, we highlight how much of the difference in Magnetic resonance imaging (MRI) consumption between high and low MRI-utilization districts is explained by observable characteristics and how much is owed to unobserved differences, which can be interpreted as an approximation of the difference due to medical practice variation
Some districts in Upper Austria and Styria have very low MRI utilization with rates not even half of those found in the high MRI-utilization districts
Summary
In their quest to align healthcare expenditure with actual revenues, policy makers can find viable options in the reduction of wasteful spending. The Organisation for Economic Co-operation and Development (OECD) defines wasteful spending on health as expenditures that do not yield adequate medical benefits for patients [1]. Policy makers can increase the efficiency of healthcare systems without cutting back on vital services. Spotting wasteful spending in practice is not trivial. Medical practice variation can serve as helpful signpost in these endeavours. In the absence of plausible epidemiological explanations, regional differences in the use of specific healthcare services provide ample reason for researchers to question the efficiency of resource deployment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
