Study Reveals Higher Cost Emergency Care Yields Better Outcomes

Despite studies suggesting higher spending levels do not necessarily produce better health outcomes, a new paper to be published in the Journal of Political Economy found the opposite to be true with regard to emergency care.

The researchers analyzed Medicare billing data for patients with 29 types of serious conditions in 40 communities to determine the medical services provided to them.

“If the question is, ‘Do high-spending hospitals get better outcomes for emergency care?’—we think that they do,” Joseph Doyle, Massachusetts Institute of Technology economist and lead author, said in a statement. “We do find that if you go from a low-spending hospital to a high-spending hospital, you get significantly lower mortality rates.”

The authors assessed ambulance-dispatch patterns in New York state over several years to determine how similar groups of patients fare after receiving varying levels of treatment. According to Mr Doyle, the researchers were aiming for a better “apples-to-apples comparison” than is available in previous research.

He added that the findings from their study suggests caution in the interpretation that there is huge waste in the medical system. Their estimates imply that a one standard deviation increase in Medicare reimbursement would lead to a 10% reduction in mortality. Furthermore, the cost per one year of life saved is about $80,000.

“If we’re trying to find out where the waste is, our research suggests it’s not in emergency care,” Mr Doyle says.

A recent paper in The American Journal of Managed Care found that retail clinics can be as good as or better than urgent care clinics or emergency rooms when it comes to the quality of care provided as well as more cost effective.

“With increasing calls for healthcare delivery systems that can reduce the cost of care, offer more convenient primary care options to patients, and address primary care shortages, retail clinics may offer an attractive option,” William H. Shrank, MD, MSHS, chief scientific officer at CVS Health, and colleagues wrote.