"Adjusted inpatient mortality was negatively associated with hospital spending for all six diagnoses, meaning those admitted to hospitals that spent the most were less likely to die in the hospital than were patients admitted to hospitals that spent the least," said Goldman, Norman Topping Chair in Medicine and Public Policy at USC and director of the Schaeffer Center at USC.
In their analysis, the researchers accounted for patients who have additional life-threatening conditions, such as AIDS or cancer. They adjusted for hospital, regional and socio-demographic differences that might correspond to variations in health, such as median household income in patients' neighborhoods.
The researchers estimated the number of lives that might have been saved if all patients in the sample were admitted to the highest-spending hospitals rather than to the lowest-spending hospitals, including 5,198 lives from heart attack, 11,089 lives from pneumonia and 7,467 lives from stroke.
In 2004 to 2008, the period for which the researchers had disease-specific cost data, the highest-cost hospitals spent three to five times more than the lowest-cost hospitals. For example, the highest-spending hospitals (top one-fifth) spent an average of $21,072 on each patient who had suffered a heart attack, compared to an average of $5,168 by the lowest-spending hospitals (lowest one-fifth).
Variations in hospital spending may be incurred by time spent in the intensive care unit, use of specialists, diagnostic tests and imaging, and medical procedures, including mechanical ventilation and dialysis.
"While our analysis demonstrates that intensive spending by hospitals is associated with lower mortality, it does not identify the specific costly interventions that high-spending hospitals undertake to achieve this mortality benefit," Romley said
|Contact: Suzanne Wu|
University of Southern California