Economist Links Higher ER Spending to Lower Mortality

John Commins, for HealthLeaders Media , July 27, 2011

Doyle analyzed the patient data by ZIP code, age, and even season of the year to make sure that he was studying demographically similar tourists being treated throughout Florida.

Doyle said Florida is a microcosm of the nation, because the state has significant variations from place to place in how patients are treated for heart attacks, and per capita income for a particular area does not correlate with hospital spending. 

As a result, the variations Doyle found do not stem from the prior health of patients, but from the level of care itself. Specifically, the greater expenses — and benefits — in heart treatment seem to come from a broader application of ICU tools and having more medical personnel on hand. "The higher-spending hospitals use more ICU services, and they have higher staff-to-patient ratios, so they use more labor. And that's expensive," Doyle said.

Doyle said he has yet to identify the precise medical technologies that provide the greatest additional benefit per dollar spent. "There are smart ways to spend money and ineffective ways to spend money, and we're still trying to figure out which are which, as much as possible," he said.



John Commins is a senior editor with HealthLeaders Media.

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