Physicians' use of health resources for terminal cancer patients: clinical setting versus physician specialty.

A large proportion of all Medicare reimbursements (22%) are made for terminally ill patients. Alternative methods of care for such patients (for example, hospice care) may be more appropriate and less costly. The role of physician characteristics in determining use of resources for terminal patients is compared with that of care setting (type of facility), using data from the National Hospice Study. Multiple logistic regression reveals a stronger relationship between care setting and resource utilization than between physician "aggressiveness" and utilization. Physician specialty has little effect on utilization. These findings suggest that care setting may influence physician practice behavior. This may be due to self-selection of particular types of physicians or patients, or to a characteristic of the facility itself.