As a marker for hospital quality, cost alone is unreliable, new study suggests

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You might think that higher-cost medical care means higher-quality medical care or, rather, that lower-cost medical care means lower-quality medical care. Neither are reliable assumptions.

In a Commonwealth Fund-backed study published online today in the Archives of Internal Medicine, researchers at the University of Michigan and elsewhere analyzed discharge data and outcomes for Medicare patients with congestive heart failure or pneumonia.

When it came to congestive heart failure, hospitals that spent a lot of money ranked higher in quality of care. Their patients were also less likely to die of the condition in the next 30 days.

But when it came to pneumonia, hospitals that spent the least money ranked higher in quality of care. And their patients were less likely to die in the next 30 days of pneumonia.

The research would seem to hold lessons for lowering healthcare costs across the board, but as an accompanying editorial notes:

‘To increase progress on lowering hospital costs without harming quality, we need more comparative effectiveness studies -- specifically, studies that show that 2 interventions of different costs are of equal value.’

Yes. Yes, we do.

Here’s the abstract from the study, the synopsis offered by the Commonwealth Fund, and more on hospital quality from the U.S. Department of Health & Human Services, including (not exciting, but undeniably important) information on process-of-care measures and outcome-of-care measures.

-- Tami Dennis