Dartmouth Atlas analyses of hospital spending called 'flawed'

Feb 18 2010

The New York Times reports that certain hospitals, including the Mayo Clinic, are lauded "for delivering high-quality care at low costs" based on "a widely cited analysis called the Dartmouth Atlas of Health Care." But a report in "The New England Journal of Medicine by Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center in Manhattan, suggests that much of the Dartmouth Atlas is flawed and that it should not be used to compare the relative efficiency of hospitals. ... The arguments are arcane, but ... they could have profound effects on how medicine is delivered and paid for in the United States."

"Dr. Bach argues that the comparisons make no effort to determine if the hospitals are any better at saving people's lives, and do little to adjust for the relative health of the patients being treated, among other problems." In response, "Dr. Elliott S. Fisher, director of the Center for Health Policy Research at the Dartmouth Institute, said the larger issue was that just because a hospital charges a lot does not mean that it delivers good care" (Harris, 2/17).

Related, earlier KHN story: Crusading Professor Challenges Dartmouth Atlas On Claims Of Wasteful Health Care Spending (Rau, 11/16)