Increased healthcare spending doesn't lower mortality rates

Greatly increased healthcare spending on specific treatments did not result in a commensurate reduction of mortality rates, according to a study by researchers at Tufts University and UC San Francisco published in the journal Health Affairs.

The study examined patients at 122 hospitals treated for strokes, myocardial infarctions, sepsis, community-acquired pneumonia, congestive heart failure, urinary tract infections and chronic obstructive pulmonary disease. The patients ranged in age from 18 to 86.

Researchers concluded that costs rose far out of proportion to decreases in mortality. For example, the cost of treating sepsis rose 41 percent between 2000 and 2004, while the mortality rate was flat. The costs for treating congestive heart failure rose 60 percent during that same time period, while mortality rates declined just 19 percent.

Although the study did not comment on the phenomenon directly, the cost of saving each additional life was high. It ranged from $167,000 for each additional pneumonia patient saved, to $1.8 million to save an additional patient suffering from sepsis.

However, using inexpensive medicines to treat myocardial infarction patients--such as aspirin and beta-blockers--provided a much higher value in older patient groups compared to techniques used more aggressively among younger patients, such as revascularization (coronary artery bypass grafts), noted researchers.

"Healthcare dollars provide inconsistent value, and future spending increases should be targeted to care that improves outcomes," the study's authors concluded.

To learn more:
- read the Health Affairs study