You Get What You Pay For

Not necessarily. It is being reported in the New York Times today by Reed Abelson that a study of 60 Pennsylvania hospitals performing the same cardiac surgery had vastly different outcomes and costs. Some of the hospitals charged as much as $100,000 and did not do as well as some of the hospitals doing the same surgery at a cost of $20,000.

Two of the twenty local Philadelphia hospitals charging the most had higher deaths than expected. One of the lowest charging hospitals had a better than expected success rate.

Overall, higher cost does not mean better care or success. Why is that?

2 Comments so far

  1. jack (unregistered) on June 14th, 2007 @ 9:58 pm

    it’s so confusing… lawyers and businessman run medicine these days not doctors and patients.

    most of the differences come from patient selection. in wealthy suburbs patients are in generally better health than in underserved populations. if patients are too “tough” they get referred to places like Penn or Jeff.

    the second thing is for profitable procedures like coronary artery bypass and angioplasty there is an incentive to do more… more profit oriented places have a low threshold to do these (most heart attacks are small don’t necessarily need intervention). Whereas university settings (jeff penn) will be more strict. meaning many people who may not have been sick enough to deserve it get it at some places. naturally these people tend to do better as they aren’t that sick to begin with. this is again patient selection

    having trainees aka teaching hospital dramatically raises costs.

    do you know in one year philadelphia had more lawsuits than the state of california in two. practicing medicine in philly dramatically raises cost

    So IMO going to a university hospital you will get much better care. Usually patients don’t like being prodded by 10 trainees a day and it’s less pleasant. But if it’s something complicated or somewhat important (heart brain) go downtown


  2. CarlaJ (unregistered) on June 15th, 2007 @ 11:08 pm

    I work at a private allied healthcare school and a local community college that teaches medical procedures such as cardiovascular testing, ekg, holter, stress tests, IV’s, blood drawing etc.
    The owner?
    Knows nothing about medicine or could really care less if you do.
    The college? Its a well known named school. I would not trust my CAT to with some of these “graduates”, let alone to assist a patient. Many times if you “pay” in the midnight hour students have made up all thier imaginary lab hours and can now get a certificate and draw blood from people or sit for NCLEX LPN or RN certification.

    EVERYTHING is BUSINESSS. Not just down to the hospitals, but down to the TRAINING. I have seen it in nursing schools, community colleges etc

    You would be HORRIFIED if you knew the ACTUAL training THAT PA nurses “get by” with.

    The entire healthcare profession is such a disgrace, a family friend and her husband are employed at one of the largest hospital/universitiy networks in PA in which their child could go for free.

    They KNOW the REAL deal on the quality and opted to work extra hours for her to go ELSWHERE to get a REAL education, not a “BRAND NAME”

    So many people out there are “pseudo competent” They went to the big school and learned from the best, so they are the best right?

    Do you get what you pay for?

    I had an idiot nurse at what is called a TOP PA Hospital give my cousin MOTRIN when her chart said she was allergic to IBUPROPHEN. She claimed they did not teach her in school that they were one and the same. Needless to say she blew up like a blowfish and suffered an extra 2 days after having her first child…at PENN

    Did I mention my cousin is an alumni of the PENN university/hospital? Boy, some way to treat someone who is still paying off that 60,000 dollar education …

    No trust me. It’s not CERTAIN hospitals, its the healthcare field in a big ol happy nutshell.

    How about why people are dying??? Maybe these doctors think they are too good to stay cleam. Maybe someone died from infection??? DOCS SAY THEY DONT HAVE TIME TO WASH THIER HANDS.

    see link on edictorial about doctors not washing their hands and killing thousands with infected dirty hands. My grandmother died from a MRSA infection from dirty hands from her doctor in the 80’s and it continues to get worse…(Jefferson)

    http://www.journals.uchicago.edu/cgi-bin/resolve?id=doi:10.1086/501888&erFrom=3045573118104178007Guest



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