Does Increased Hospital Spending Reduce Mortality?

According to Romley, Jena and Goldman (2011), the answer is yes. For each of 6 diagnoses at admission—acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia—patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality. During 1999 to 2003, for example, patients admitted with acute myocardial infarction to…

Why is end-of-life spending so high?

The answer is because using more intensive services does reduce mortality. This is the finding of a recent JAMA paper. After controlling for patient case mix, the authors examine variation in hospital spending in the last year of a patient’s life. The authors note that “Higher-spending hospitals differed in many ways, such as greater use…

Is Medicare cost growth slowing?

Ezra Klein reports that this may in fact be the case according to S&P Healthcare Economics. “This chart shows per-patient Medicare revenue falling to a 2.5 percent growth rate, the lowest since S&P Indices started tracking numbers six years ago. At the very top of the this chart you see the ‘commercial index’ — which…

Does spending improve outcomes?

From a paper by Weinstein and Skinner (NEJM 2010): “Moreover, there is considerable variation in health care expenditures and a weak or even negative association between spending and outcomes, such as mortality at the regional level and quality measures at the state level. This evidence has been interpreted to mean that cutting back on these…