JAMA study: Higher spending = better quality in Canadian hospitals

Mar 15 2012

The study in the Journal of the American Medical Association appears, at first blush, to contradict findings from the Dartmouth Atlas research.

Bloomberg: Canadian Hospitals That Spend More On Patients Get More
Canadian hospitals that spent the most on patient care may be getting a bigger bang for their buck than their U.S. counterparts, researchers suggested. A study reported in the Journal of the American Medical Association compared patient results between Canadian hospitals that spent more on care, and those that spent less (Armstrong, 3/14).

Reuters: More Spending Equals Better Care - In Canada
The finding raises questions about an idea at the heart of a major argument in U.S. health care reform: that hospitals can provide equal or even better care after government reimbursements are cut (Pittman, 3/13).

MedPage Today: Best Care May Be At Hospitals That Spend Most
At baseline, illness severity among patients with each condition did not vary based on the hospitals' spending intensity. In general, patients treated at higher-spending hospitals had longer lengths of stay, a lower likelihood of being admitted to the intensive care unit, and more specialist visits and nursing care (Neale, 3/13). 

Modern Healthcare: Higher-Spending Facilities Tied To Better Survival, Lower Readmissions, Study Finds
Heart failure, hip fracture and colon cancer patients at high-spending Canadian hospitals were less likely to return to the hospital or die soon after being treated than those treated at low-spending hospitals ... [the research] analyzed 30-day and one-year readmissions and death rates for adults admitted to Canadian hospitals between 1998 and 2008 (Evans, 3/13).

Kaiser Health News: Capsules: Study Finds High-Spending Canadian Hospitals Do Better
At first glance, this conclusion would seem to contradict the world view of the Dartmouth Atlas, which maintains that American hospitals that throw more resources at patients -; more specialists, tests, procedures -; don't get better results. ... But the paper explains that Canadian hospitals have far fewer resources than do American ones (Rau, 3/13).

HealthyCal: Canadian Study Says Patients Fare Better In Higher-Spending Hospitals
Taken together, both of the studies suggest that there are limits to the health benefits that can be achieved with more spending, as there are diminishing returns as more medical technology and specialized services are used. Canada's health care expenditures per capita are about 57% those of the U.S., which has a 3- to 4 times higher per capita supply of specialized technologies, including MRIs and CAT scans, and triple the number of specialists (Portner, 3/13).