Hospitals that spend more on emergency care yield better outcomes
Hospitals that spend more on initial care following patient emergencies have better outcomes than hospitals that spend less at first and rely more on additional forms of long-term care, according to a new study co-authored by MIT economists.
More specifically, hospitals that invest more in inpatient care yield better results, per dollar spent, than those that assign relatively more patients to skilled nursing facilities upon discharge. Other things being equal, allocating a higher percentage of overall health care expenses to a hospital’s inpatient treatment is consistent with lower mortality rates among elderly Medicare recipients.
“We find that patients who go to hospitals that rely more on skilled nursing facilities after discharge, as opposed to getting them healthy enough to return home, are substantially less likely to survive over the following year,” says Joseph Doyle, the Erwin H. Schell Professor of Management at the MIT Sloan School of Management and co-author of a paper detailing the study.
Conversely, Doyle adds: “What types of hospitals are low-cost and have good outcomes? They spend a lot when you’re there, initially, but a lot less [after] you leave the hospital.”
The paper, “Uncovering waste in US healthcare: Evidence from ambulance referral patterns,” appears in the July issue of the Journal of Health Economics. The co-authors are Doyle; John A. Graves, an assistant professor at Vanderbilt University; and Jonathan Gruber, the Ford Professor of Economics at MIT.