Certified in Public Health (CPH) Practice Exam

According to John Wennberg and colleagues, variations in Medicare expenditures across geographic areas are primarily due to differences in:

1. Physician practice styles

2. Consumer preferences for high-cost services

3. Age of the population served

4. Health status of the population served

The correct answer is: Physician practice styles

The correct response highlights that variations in Medicare expenditures across geographic regions are primarily influenced by physician practice styles. This concept stems from the research conducted by John Wennberg and his colleagues, who discovered significant discrepancies in healthcare spending that could not be solely attributed to demographic factors, such as population age or health status. Physician practice styles encompass the different ways in which doctors approach patient care, including diagnostic practices, treatment decisions, and referral patterns. These individual styles can lead to differences in the volume and types of services provided, affecting cost without necessarily improving health outcomes. For example, one region might have physicians who are more likely to recommend procedures and specialist referrals, leading to higher expenditures, while another region may practice more conservatively, focusing on primary care and less invasive treatments. The other choices, while relevant in understanding healthcare dynamics, do not capture the primary driver of expenditure variation as effectively as physician practice styles do. Consumer preferences can influence demand for services, but the significant impact of physician decision-making and clinical judgment remains pivotal in determining costs. Similarly, factors like the age and health status of a population do play a role in overall healthcare expenses, yet they account for variability far less than the individual variations in physicians’ styles of practice.