Dartmouth Redux
Researchers are backing away from earlier statements used to support White House claims about reducing waste. This is from The New York Times:
Last June, as Mr. Obama campaigned for his health care overhaul, he visited Green Bay, Wis., praising the city for getting “more quality out of fewer health care dollars than many other communities.”
Two of Green Bay’s hospitals, Bellin and St. Mary’s Hospital Medical Center, rank fourth and 11th within Wisconsin on the Dartmouth list.
But…Dartmouth ranks hospitals only by costs and number of treatments and procedures. A different picture emerges from work done by the Wisconsin Collaborative for Healthcare Quality, a voluntary group of health care organizations that uses both price and quality of care measures. In an analysis of heart attack care, for example, it ranks Bellin second, and St. Mary’s 15th, among the 22 hospitals in the state.
And a Medicare ranking based on its own data that shows how many people die after treatment for certain conditions — statistics that exclude costs entirely — puts Bellin fifth, but drops St. Mary’s to second-to-last: 67th of the 68 hospitals statewide that were measured by both Dartmouth and Medicare.
Do the Green Bay hospitals favored by Dartmouth really offer better care? Maybe not.
Have the metrics currently used to measure cost and quality care been adequately tested for reliability? Definitely not.
A problem with the Dartmouth Atlas is that it assumes Medicare spending is a proxy for total health expenditures in a region.
Research by NCPA senior fellows Thomas Saving and Andrew Rettenmaier discovered that variations in Medicare spending are often offset by non-Medicare spending.
Didn’t the NCPA debunk a lot of what Darmouth was saying in an earlier study?
Along with NCPA, Richard Cooper of Wharton showed that the Dartmouth group’s use of Medicare as a proxy for private care is incorrect. It was in a December 2008 Health Affairs article.
John before you print this material you should read and provide both sides of the story. Here is Dartmouth’s response — http://www.dartmouthatlas.org/downloads/press/Factual_errors_NYT_article.pdf
http://www.hcbn1.com
I try to keep up with what Darmouth has published and I don’t believe it justifies Peter Orszag’s claims about how the government can use the information to save $700 billion a year.
[…] researchers to task in a front page article and columnist David Leonhardt piled on. I also weighed in at this blog and the Dartmouth folks defended themselves […]
John,
So the political elite use Dartmouth Atlas to justify top down control. Why don’t you use it as a jumping off point to emphasize the great variation in price/quality/practices. We know the market will crush high prices, poor quality, and questionable practices.
Long time reader / first time poster. Really enjoy reading the blog, keep up the excellent work. Will definitely start posting more oftenin the future.