Associations between Hospital Quality Outcomes and Medicare Spending per Beneficiary in the USA

Cook, Karyn; Foster, Brent; Perry, I’sis; Hoke, Christy; Smith, Dana; Peterson, Leanne; Martin, John; Korvink, Michael; Gunn, Laura H.

doi:10.3390/healthcare9070831

Open AccessArticle

Associations between Hospital Quality Outcomes and Medicare Spending per Beneficiary in the USA

by

Karyn Cook

^1,2,

Brent Foster

^1,2,

I’sis Perry

^1,2,

Christy Hoke

^1,2,

Dana Smith

^1,2,

Leanne Peterson

^1,2,

John Martin

³,

Michael Korvink

³

and

Laura H. Gunn

^1,2,4,*

¹

Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC 28223, USA

²

School of Data Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA

³

ITS Data Science, Premier, Inc., Charlotte, NC 28277, USA

⁴

Faculty of Medicine, School of Public Health, Imperial College London, London W6 8RP, UK

^*

Author to whom correspondence should be addressed.

Healthcare 2021, 9(7), 831; https://doi.org/10.3390/healthcare9070831

Submission received: 22 May 2021 / Revised: 24 June 2021 / Accepted: 26 June 2021 / Published: 1 July 2021

(This article belongs to the Special Issue Health Care Management and Cost Estimation)

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Abstract

The cost of healthcare in the United States has increased over time. However, patient health outcomes have not trended with spending. There is a need to better comprehend the association between healthcare costs in the United States and hospital quality outcomes. Medicare spending per beneficiary (MSPB), a homogeneous metric across providers, can be used to evaluate the association between episodic Medicare spending and quality of care. Fifteen inpatient outcome measures were selected from Hospital Compare data among all (n = 4758) facilities and transformed to quintiles to ensure comparability across measures and to reduce the influence of outliers on the analysis. Both univariate and multiresponse multinomial ordered probit regression models were utilized across outcome domains to quantify associations between outcomes and spending. We found that MSPB was not associated with quality of care in most cases, adding evidence of a lack of outcome accountability among Medicare-funded facilities. Furthermore, worse outcomes were found to be associated with increased spending for some metrics. Policies are needed to align quality of care outcomes with the increasing costs of U.S. healthcare.

Keywords: Medicare spending per beneficiary; Hospital Compare; multiresponse multinomial ordered probit; hospital quality outcomes

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MDPI and ACS Style

Cook, K.; Foster, B.; Perry, I.; Hoke, C.; Smith, D.; Peterson, L.; Martin, J.; Korvink, M.; Gunn, L.H. Associations between Hospital Quality Outcomes and Medicare Spending per Beneficiary in the USA. Healthcare 2021, 9, 831. https://doi.org/10.3390/healthcare9070831

AMA Style

Cook K, Foster B, Perry I, Hoke C, Smith D, Peterson L, Martin J, Korvink M, Gunn LH. Associations between Hospital Quality Outcomes and Medicare Spending per Beneficiary in the USA. Healthcare. 2021; 9(7):831. https://doi.org/10.3390/healthcare9070831

Chicago/Turabian Style

Cook, Karyn, Brent Foster, I’sis Perry, Christy Hoke, Dana Smith, Leanne Peterson, John Martin, Michael Korvink, and Laura H. Gunn. 2021. "Associations between Hospital Quality Outcomes and Medicare Spending per Beneficiary in the USA" Healthcare 9, no. 7: 831. https://doi.org/10.3390/healthcare9070831

APA Style

Cook, K., Foster, B., Perry, I., Hoke, C., Smith, D., Peterson, L., Martin, J., Korvink, M., & Gunn, L. H. (2021). Associations between Hospital Quality Outcomes and Medicare Spending per Beneficiary in the USA. Healthcare, 9(7), 831. https://doi.org/10.3390/healthcare9070831

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Associations between Hospital Quality Outcomes and Medicare Spending per Beneficiary in the USA

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