More expensive emergency care means better outcomes

Spending more on emergency care results in better patient outcomes, according to a study from MIT soon to be published in the Journal of Political Economy.

Researchers, led by MIT economist Joseph Doyle, assessed several years' worth of New York ambulance-dispatch patterns to determine various levels of treatment's effects on similar groups of patients. Doyle and his team analyzed Medicare billing records for 29 serious conditions in 40 communities and found that upping spending for emergency care one standard deviation above the mean reduced mortality by about 10 percent.

By using these variations, Doyle said, researchers hoped to get "a better apples-to-apples comparison" than previous research, which has not always controlled for variation in types of patients.

"If the question is, 'Do high-spending hospitals get better outcomes for emergency care?'--we think that they do," Doyle said in an announcement from MIT. "We do find that if you go from a low-spending hospital to a high-spending hospital, you get significantly lower mortality rates."

The research conflicts with the healthcare industry's current focus on achieving better outcomes with lower spending. Healthcare spending is projected to be a major driver of federal budget deficits over the next few years, with spending on Medicare, Medicaid and other federal healthcare programs reaching 5.3 percent of gross domestic product by 2016 and 6.2 percent by 2025, according to a recent report by the Congressional Budget Office.

Freestanding emergency departments, which have grown in popularity in recent years, have also come under criticism for their high costs, despite their convenience, FierceHealthcare previously reported.

Although Doyle did not conclude there is no waste in healthcare spending, he noted that evidence shows that emergency care is not a major area for such waste. "If we're trying to find out where the waste is, our research suggests it's not in emergency care," he said.

To learn more:
- here's the study abstract (second from top)
- read the announcement