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Greater spending not tied to higher quality, study says


By Jean DerGurahian
Posted: May 20, 2009 - 11:15 pm ET
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Greater spending on treatment was not related to higher quality of care in an assessment of individual hospitals published in the latest Health Affairs.

Researchers from the Dartmouth Institute for Health Policy and Clinical Practice studied the relationship between higher end-of-life spending on care—including use of resources such as specialists, tests and hospital departments—and process-of-care measures for acute myocardial infarction, pneumonia and heart failure. The study reflects data for 2,712 U.S. hospitals using information from the CMS’ Hospital Compare Web site and Medicare spending reports.

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Hospitals that spent more on care did not necessarily perform higher on the quality measures, according to the study. The researchers found no association between performance on the heart failure measures and spending, but hospitals that spent less did better in meeting requirements for AMI and pneumonia care.

“We found no evidence that hospitals with higher spending provided better care, whether we looked at all hospitals across the country, or limited our study to academic medical centers, or hospitals within a single region. In fact, in some cases hospitals that spent more provided worse care,” said Laura Yasaitis, a medical student at Dartmouth Medical School and a researcher with the Dartmouth Institute who co-authored the study, in a written statement.

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