Market variations in intensity of medicare service use and beneficiary experiences with care

Abstract

Objective. Examine associations between patient experiences with care and service use across markets. Data Sources/Study Setting. Medicare fee-for-service (FFS) and managed care (Medicare Advantage [MA]) beneficiaries in 306 markets from the 2003 Consumer Assessments of Healthcare Providers and Systems (CAHPS) surveys. Resource use intensity is measured by the 2003 end-of-life expenditure index. Study Design. We estimated correlations and linear regressions of eight measures of case-mix-adjusted beneficiary experiences with intensity of service use across markets. Data Collection/Extraction. We merged CAHPS data with service use data, excluding beneficiaries under 65 years of age or receiving Medicaid. Principal Findings. Overall, higher intensity use was associated (p