WASHINGTON – Higher spending for Medicare does not necessarily translate into better care, says a study that found patients got less effective treatment in states that spent more on medical specialists.

Dartmouth College researchers studied how often doctors caring for Medicare patients used high-quality, low-cost treatments proven effective for most people.

The 24 treatments measured in the study included prescribing aspirin and beta blockers for heart patients, antibiotics for pneumonia sufferers, mammograms for older women and eye exams for diabetic patients.

Evidence had shown that states varied widely in their use of these treatments, leading the researchers to question whether states lacking effective treatments didn’t spend enough on Medicare.

“The answer is no,” said study author Katherine Baicker, assistant professor of economics at Dartmouth. “In fact, in the areas where we see the highest spending, if anything there’s a lower use of this care.”

Baicker and Amitabh Chandra, also an assistant professor of economics at Dartmouth, said they discovered that the states spending the most put those dollars into intensive, expensive care instead of more effective basic treatments.

The higher-spending states also had greater concentration of specialists. States that spent less and delivered better care tended to have more general practitioners.

“New England in general seems to be doing a very good job of providing effective medical care,” Baicker said.

New Hampshire, which receives about $5,000 per patient, was at the low end of Medicare reimbursement rates. Louisiana, which had the lowest overall quality ranking, received more than $8,000 per patient.

Behind New Hampshire, Vermont and Maine were ranked second and third in the delivery of high quality care. The study matches findings by a government study in January 2003 that ranked New Hampshire, Vermont and Maine 1-2-3 in the quality of care they provide.

The study doesn’t explain why regions with more specialists delivered less effective care. Baicker said it’s possible that specialists concentrate on sophisticated testing, letting the more basic and effective treatments fall through the cracks.

Specialists might also spend more time treating an acute condition and less time inquiring about a patient’s general health, compared with a general practitioner.