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The Failure of Physician Education as a Cost Containment Strategy
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1984
Year
Family MedicineHealth Care AccountingEducationPhysician EducationHealth Care FinanceHospital MedicineTotal Hospital CostsManaged CarePublic HealthHealth Services ResearchHealth PolicyOutcomes ResearchCost EffectivenessHealthcare ValueHospitalizationHealth EconomicsMedical MalpracticeHealth Care ReimbursementContinuing Medical EducationPatient EducationHealth Services CompetitionHealth Care CostHealth Services ManagementHealth Profession TrainingMedicineEducation PolicyLarge University Hospital
The study tests whether physician education can reduce total hospital costs. A prospective controlled study over two academic years at a university hospital evaluated three educational interventions—weekly cost‑containment lectures, audit with feedback, and a combined dose—among 1,663 patients and 226 house staff. The interventions did not significantly reduce total hospital charges, and although some service use declined, the overall impact was insufficient to lower costs, indicating that physician education alone is ineffective for cost containment. Published in JAMA 1984;252:225-230.
To test the hypothesis that physician education is an effective strategy to reduce total hospital costs, we evaluated three educational interventions at a large university hospital. This prospective controlled study spanned two academic years and involved 1,663 patients and 226 house staff. In the first year, weekly lectures on cost containment (medicine and surgery) and audit with feedback (medicine only) both failed to produce a significant change in total hospital charges. The "dose" of the intervention was increased on medicine in the second year by combining the lecture and audit strategies. Again, total charges did not change significantly. While decreased use occurred for certain selected services, the impact was not great enough to affect total hospital charges significantly. We conclude that, in the absence of other cost containing incentives, physician education alone is not an effective hospital cost containment strategy. (<i>JAMA</i>1984;252:225-230)