Bad Hospital, Good Hospital: Variation Can Be Seen In the Same Neighborhood

And it could be a matter of luck which one patients will be sent to. That’s because a study in PLOS One that discovered that hospital quality varied not just by region or city, but even by a few streets, could gather the information only if it did not use participating hospitals’ names. But researchers managed to dig out a ton of data after examining 22 million hospital admissions covered by private insurers and Medicare.

Get this. Patients admitted to the worst American hospitals were 13 times more likely to have medical complications and three times more likely to die than if they visited one of the best hospitals.

Barry Rosenberg, MD, the study’s lead author and a partner at the Boston Consulting Group in Chicago, said that he wanted to undermine the public’s idea that hospitals are essentially the same. He tells the New York Times that, for instance, if someone has a heart attack, the closest hospital could have a death rate of 16%, where it could be 4% in one a little farther away. In addition, a hospital may have great outcomes for heart attacks, but poor ones for knee replacement.

Researchers analyzed the admissions using two-dozen measures of medical outcomes and after adjusting for various factors, such as age, income, and how sick the patients were, discovered widespread differences in quality.  

The study states: “These findings suggest that: 1) additional examination of regional and local variation in risk-adjusted outcomes should be a priority; 2) assumptions of uniform hospital quality that underpin rationale for policy choices (such as narrow insurance networks or antitrust enforcement) should be challenged; and 3) there exists substantial opportunity for outcomes improvement in the US healthcare system.”

Source: PLOS One