2011 January 31 Monday
Big Spending Hospitals Better For Emergency Care

While much of medical spending is just waste big bucks make for better outcomes when you come in near death.

Studies have shown that regions spending more on medical care, such as Miami, do not have better health outcomes than regions that spend relatively less, such as Minneapolis. However, less is known about how medical spending affects health at certain critical times, such as in the immediate period after a patient is admitted to the hospital with a life-threatening condition.

When hospitalized for a major acute medical condition including heart attack, stroke and pneumonia patients were less likely to die in high-spending hospitals, according to a new study appearing in the Feb. 1 issue of the Annals of Internal Medicine.

The findings inform the ongoing discussion on how to curb health care spending.

"Our findings suggest that while regions spending more on health care generally produce no better care, specific types of medical spending, such as acute-care hospital spending, may save lives," said John Romley, an author of the study and an economist with the Schaeffer Center for Health Policy and Economics at USC, which is supported by the USC School of Policy, Planning, and Development and the USC School of Pharmacy.

If you must have a heart attack do it near a hospital that generates high costs per patient.

For example, from 2004 to 2008, patients admitted for heart attack to the top-spending hospitals were 19 percent less likely to die than patients admitted to the lowest-spending hospitals. From 1999 to 2003, patients admitted for heart attack were 9 percent less likely to die at the highest-spending hospitals than at the lowest-spending hospitals.

"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.

What I wonder: Are technological advances increasing the power of the most intense forms of treatment in response to acute crises?

Another way to avoid dying in a hospital: Go to a hospital that follows checklists of best practices. Yes, it is necessary for top-down rules to enforce best practices on doctors and nurses. In absence of a checklist hospital workers make many more mistakes and do not follow best practices and lots of people die as a result.

Share |      By Randall Parker at 2011 January 31 11:44 PM  Economics Health


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