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The researchers suggest that targeting malpractice concerns could help reduce the regional differences.
"We need a way for docs to be less afraid of not ordering a test," said Lucas.
Medical malpractice was part of the health care reform debate, but didn't make it into the recently approved legislation. The new law does include pilot programs for states to explore alternatives to lawsuits.
The study was released Tuesday by the journal Circulation: Cardiovascular Quality and Outcomes.
The results support moving toward more integrated health care, and away from fee-for-service payments, and working on malpractice reforms, said Kenneth Thorpe, a professor of health policy at Emory University in Atlanta.
Lucas said patients can help by not pressuring their doctors to do tests.
"If he says you don't need it, let it go," she said.
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