Comparing Outcomes and Charges for Patients with Acute Myocardial Infarction in Three Community Hospitals

An Approach for Assessing "Value"

Published In: International Journal For Quality In Health Care, v. 7, no. 2, June 1995, p. 95-108

Posted on RAND.org on January 01, 1995

by Eugene C. Nelson, Sheldon Greenfield, Ron D. Hays, Celia Larson, Beth Leopold, Paul Batalden

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Assesses the value of care (outcomes in relation to charges) for patients with acute myocardial infarction (MI). Data were obtained from medical records and patient-completed questionnaires of 133 patients at three community hospitals. After adjustment for patient-mix, Hospital C scored significantly better on four of six outcome measures (angina, dyspnea, physical functioning, and psychosocial functioning), whereas Hospital A scored significantly lower on the three resource intensity indicators (length of stay, ancillary charges, and total charges). Comparisons among hospitals on adjusted mortality and satisfaction did not differ significantly. The authors conclude that one would prefer Hospital C if outcomes were the basis for choice. Hospital A would be preferred if the choice was based on cost. This work represents a potentially significant beginning in understanding the relationship between costs and quality in patients with acute MI.

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