More care isn't always better, patients say

More than 2,000 Medicare patients around the country were asked by phone and mailed questionnaire whether their needs were met, what they thought about the quality of their care as outpatients, and how they would rate their overall medical care.

People living in high-expenditure areas got more medical care than those living in lower-cost areas, judged by such measures as physician visits and cardiac tests. But when asked how they felt about their treatment, more patients living in lower-expenditure areas gave their quality of care top marks (9 or 10 on a scale of 0 to 10) than their peers in the high-priced parts of the country, by a margin of 63.3 percent compared to 55.4 percent.

“The results taken together document that spending more on medical care does not improve patient’s perceptions of the medical care they receive,” the authors write.

In an accompanying editorial, Gerard F. Anderson and Dr. Kalipso Chalkidou of the Johns Hopkins Bloomberg School of Public Health write that the United States may have reached the point of diminishing returns for spending on medical care.

"When patients are able to access good-quality objective information on the risks and benefits of the various treament alternatives, they do not necessarily choose more aggressive or more costly interventions," they say.