Study finds no link between cost, quality of care

May 27 2009

Quality of care is not linked to the cost of care, according to a study published last week on the Web site of the journal Health Affairs, CQ HealthBeat reports.

For the study, researchers from Dartmouth College and Harvard University analyzed the health care bills of chronically ill Medicare beneficiaries in their last two years of life who received end-of-life care from 2,172 unidentified hospitals. The patients had one of three common conditions: heart attack, pneumonia or congestive heart failure.

The study -- sponsored by the National Institute on Aging -- looked at common quality indicators at a hospital-by-hospital level instead of regional level (Norman, CQ HealthBeat, 5/22). Researchers compared the data with some of the quality measures reported on the HHS Hospital Compare Web site (Goldstein, "Health Blog," Wall Street Journal, 5/21). The study found that among the one-fifth of hospitals that spent the least, the cost of end-of-life care was $16,059 on average. In comparison, the cost of end-of-life care at the top 20% of highest-spending hospitals was $34,742 on average. The study also found no link -- or even evidence against a link -- between spending and the quality indicators.

The researchers noted that the results might be skewed because the quality indicators they used might penalize hospitals that treat sicker patients. In addition, the study used process-of-care measures instead of patient outcomes. According to CQ HealthBeat, the findings of the study could have an effect on the debate over health care reform legislation because lawmakers and President Obama both have said that a reform plan must be able to control costs and expand access to high-quality, affordable health care (CQ HealthBeat, 5/22).

An abstract of the study is available online.