High-quality care associated with lower cost in trauma

February 22, 2011

High-quality hospitals deliver lower-cost care to trauma patients, according to a study published in the Annals of Surgery. The study found high-quality hospitals have death rates that are 34 percent lower, while spending nearly 22 percent less on trauma patient care than average-quality hospitals, suggesting high quality can coexist with lower cost.

The reason is not clear, though.

The research comes at a time when the affordability of health care in the United States is a major concern. According to the Congressional Budget Office, "total spending on health care could rise from 16 percent of the gross domestic product in 2007 to 25 percent in 2025 and to 37 percent in 2050." This study contributes to existing research seeking to better understand the relationship between quality and cost.

"There is a growing recognition that, when it comes to health care, we have a quality problem in this country," said Laurent G. Glance, M.D., lead study author and professor of Anesthesiology and Community and Preventive Medicine at the University of Rochester Medical Center. "We all want better quality and outcomes, and one possible theory is that achieving better quality may be less expensive in the long run."

One possible explanation for the new finding is that higher-quality hospitals may have fewer patient complications compared with lower-quality hospitals. Potentially preventable complications have been shown to result in greater rates of death, hospital length of stay and cost, so fewer complications could translate into cost savings.

While many studies have analyzed cost and quality in health care, this study looked at a unique patient population - trauma patients of all ages. Most previous analyses, including highly regarded research from the Dartmouth Institute, have focused on the Medicare population, made up of individuals 65 years and older.

"Trauma is mainly a disease of the young, as opposed to a disease of the elderly," noted Glance, who conducts a wide range of health outcomes research.

Glance's team analyzed data from the largest inpatient database in the United States, focusing on 67,124 patients admitted to 73 trauma centers across the country in 2006. Most patients were between 40 and 50 years old, male, and admitted to a trauma center following a car crash, fall, gunshot or stab wound, or other type of serious injury.

Researchers determined hospital quality by comparing a hospital's predicted mortality rate to its actual mortality rate. Information on the injury severity, age, gender, and pre-existing illness of a hospital's patients is used to estimate a hospital's predicted mortality rate. Trauma centers whose actual mortality rates are significantly greater than their expected mortality rates are classified as low-quality hospitals. For high-quality hospitals, actual mortality rates are significantly lower than expected mortality rates.

The research team then used mathematical models to explore the association between hospital death rates and costs.

The main limitation of the study is its design - it only provides a snapshot of trauma care quality and cost in the United States. Researchers cannot conclude increasing quality will result in lower costs. Glance said more research is needed to explore the link.
-end-
In addition to Glance, Andrew W. Dick, Ph.D., RAND, Pittsburgh; Turner M. Osler, M.D., University of Vermont Medical College; Wayne Meredith, M.D., Wake Forrest University School of Medicine; and Dana B. Mukamel, Ph.D., University of California, Irvine, participated in the research. The study was funded by the Agency for Healthcare Research and Quality.

University of Rochester Medical Center

Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.