Wennberg, et. al. "Hospital Use and Mortality among Medicare beneficiaries in Boston and New Haven." NEJM 1989;3321:1168

Conclusion: overall lower use of Medicare in New Haven did not result in an increased mortality rate over Boston

High-variation conditions (i.e., ones where there is no concensus over whether hospitalization is usefull) accounted for most of the difference

So the New Haven hospitals had a greater percentage of ill patients which made them appear to have a higher mortality rate--but the over all population rate was the same

Results

Hospitalization Rates among Medicare beneficiaries

Hospital use and reimbursement were about twice as high per capita in Boston

Overall Popluation-Based Mortality Rates

virtually the same

Mortality According to Place of Daeath and Hosptial-Associated Mortality

differences in patient death rates are a result of clinical policies not physican skill


Table of Contents

Copyright 2000 by David Black-Schaffer