Variation in medical care

The New York Times reported on a study that examined variation in outcomes of medical care provided in places across the country. The study reviewed 22 million inpatient admissions and concluded that outcomes can vary greatly, depending on where the care is received, and suggested that not all hospital networks are of the same quality. If different hospitals perform differently, regulators may need to consider whether limited provider networks (used to reduce cost) are truly adequate.

For heart attacks, it appears that more than twice the number of patients died in the worst performing hospitals than the best performing hospitals (on a risk-adjusted basis). This could be a very meaningful difference for patients. Unfortunately, the data underlying the study is not available for public use, meaning that patients cannot benefit by knowing which hospitals in their area perform better than others. Transparency would be helpful.