Related Experiment Videos
Comparing high- and low-performing hospitals using risk-adjusted excess mortality and cost inefficiency
1Department of Health Services Research, Management and Policy, University of Florida, USA. nmckay@phhp.ufl.edu
Health Care Management Review
|November 18, 2005
Summary
High-performing hospitals often are for-profit with higher occupancy and better operating margins. Low-performing hospitals tend to have more beds and higher costs, with managed care not significantly impacting performance.
Area of Science:
- Health Services Research
- Hospital Management
- Healthcare Economics
Background:
- Hospital performance assessment is crucial for quality improvement and resource allocation.
- Understanding factors differentiating high- and low-performing hospitals informs strategic decision-making.
- Previous studies have explored various metrics, but a combined approach using mortality and efficiency is key.
Purpose of the Study:
- To identify and compare characteristics of high- and low-performing hospitals.
- To analyze the relationship between hospital performance (mortality and efficiency) and specific organizational and financial attributes.
- To determine the influence of managed care on hospital performance stratification.
Main Methods:
- Utilized data from Florida hospitals between 1999-2001.
- Classified hospitals into performance groups based on risk-adjusted excess mortality and cost efficiency.
- Employed statistical analysis to compare characteristics across performance groups.
Main Results:
- High-performing hospitals were more frequently for-profit, had higher occupancy rates, and higher operating margins.
- These top performers served a greater proportion of Medicare patients and fewer Medicaid/self-pay patients.
- Low-performing hospitals were less likely to be for-profit, had more beds, higher average costs, and lower operating margins.
- Lower patient-care personnel per admission and lower personnel pay were noted in high-performing facilities.
- Managed care penetration (HMO-PPO admissions) did not significantly differentiate performance groups.
Conclusions:
- Hospital ownership, patient payer mix, occupancy rates, and staffing efficiency are significant predictors of performance.
- Cost efficiency and mortality outcomes are linked to distinct hospital characteristics.
- Managed care's role in hospital performance appears less significant than previously assumed, warranting further investigation.