Friday, April 18, 2008

Health care spending has no correlation to quality

of care but it does correlate with the supply of available beds and equipment, for chronically ill patients.


The biennial Dartmouth Atlas of Health Care is out and the findings are as eye-popping this year as they have been in the past. Among chronically ill patients in the last two years of life:

  • New Jersey patients spent almost three times as many days in the hospital as patients in Utah.
  • Patients in Manhattan had 3½ times as many hospital days as patients in Bend, Oregon.
  • Among teaching hospitals, the variation in the amount spent was more than four to one.

So what impact did this wide variation in care have on the health of patients? Not a whit.

  • There is no evidence that extra care and extra spending produce better outcomes, and some evidence that they produce worse outcomes.
  • Further, variations in care correlate with variations in supply: the more hospital beds, the more bed days; the more CT scanners, the more scans; the more cardiologists, the more cardiac care, etc. [See Associated Press article]