More Health Care Makes not Better… Necessarily.

June 2, 2008

This study shows that the intensity of care in hospitals is generally more in private providers as opposed to public ones. Yet, the result is pretty much the same.

In New York City, Two Versions of End-of-Life Care

The Dartmouth Atlas, from which the data is drawn, includes 46 New York City hospitals: 8 public and 38 private.

The Consumer Reports rankings allow consumers to look at data from hospitals across the country, and examine the intensity of care during the last two years of life. Intensity is measured by how many days the average patient spent in the hospital, how many times a doctor visited that patient and how much the patient or private insurer spent for doctors beyond what Medicare covered.

Patients in the city’s private hospitals averaged 54 visits from doctors, while those in public hospitals averaged 24 visits during the final six months. In private hospitals, 56 percent of patients saw 10 or more physicians, compared with 32 percent in public hospitals.

And private patients paid an average of $4,000 out-of-pocket over two years, nearly double the $2,200 per patient at the city-run institutions. But in terms of the ultimate outcome, there was little difference.

The Dartmouth Atlas showed that 58 percent of the public-hospital patients died in the hospital as opposed to at home or in hospice care, compared with 57 percent for private hospitals. Thirty percent of patients in public hospitals had been admitted to intensive care units before their death, compared with 27 percent in private hospitals.

Many fewer patients from public hospitals — 7 percent — were enrolled in a hospice than patients from private hospitals, where the rate was 12 percent, according to the Dartmouth data.

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