High-cost hospitals that perform poorly on quality measures treat a significantly higher proportion of Medicaid and elderly minority patients, according to a study in Health Affairs.
For the study, researchers examined hospital cost, quality, and patient demographic data from six data sources for over 3,000 U.S. Hospitals. Key findings from the study:
- The “worst” hospitals (high-cost, low quality), care for double the proportion (15 percent versus 7 percent) of elderly black patients as the “best” hospitals (low-cost, high quality)
- The “worst” hospitals care for 4% of elderly Hispanic patients, while the “best” hospitals care for 1%.
- The “worst” hospitals care for 23% of elderly Hispanic patients, while the “best” care for 15%.
- Patients with acute myocardial infarction at the “worst” hospitals were 7–10 percent more likely to die than those admitted to the "best" hospitals.
- The “best” hospitals were more likely to be non-profit, academic medical centers in the Northeast, while the “worst” hospitals were more likely to be small, for profit hospitals in the South.
- High-cost, high-quality hospitals had the best patient experiences, while low-cost, high-quality hospitals scored intermediately.
The authors conclude that in order quality to avoid financial penalties with value-based purchasing, and to avoid deepening disparities in care, poorly performing institutions will have to improve on both costs and quality.