A Simple and Interpretable Mortality-Based Value Metric for Condition- or Procedure-Specific Hospital Performance...

Area of Science:

• Health Services Research
• Health Economics
• Medical Informatics

Background:

• Assessing hospital value of care is crucial for healthcare efficiency.
• Existing metrics may lack interpretability for specific conditions or procedures.
• The value equation (Value = Quality/Cost) provides a framework for evaluation.

Purpose of the Study:

• To develop a simple, interpretable value metric (VM) for hospital care.
• To operationalize the value equation (Value = Quality/Cost) for specific conditions.
• To assess inter- and intrahospital variations in healthcare value.

Main Methods:

• Retrospective cohort study using 2015-2018 Medicare inpatient claims.
• Included cancer-related Medicare Severity-Diagnosis Related Groupings and gastrectomy procedures.
• Risk-adjusted 30-day mortality and costs were used to calculate the VM.

Main Results:

• For cancer care, the cost to prevent one excess 30-day mortality ranged from $71,000 to $1.4 billion (median $543,000).
• For gastrectomy, this cost ranged from $710,000 to $95 million (median $1.8 million).
• Substantial inter- and intrahospital variations in value were observed.

Conclusions:

• The developed VM offers a simple, interpretable way to report hospital value.
• Significant variations in value exist even among hospitals with similar quality.
• This metric can aid in understanding and improving healthcare value for specific procedures.