Lowering health care costs may mean shifting where care is delivered

How much a medical procedure costs depends on where it is performed. Giving birth at a teaching hospital, for instance, costs about $2,000 more than doing so at a community hospital. Cataract surgery at a clinic affiliated with a hospital could cost double than what it would cost at independent surgery center.

These are just some of the examples cited in a June 11, 2018 New York Times article examining variations in health care costs and the benefits and drawbacks of efforts aimed at shifting some procedures from expensive settings, such as teaching hospitals, to cheaper ones, including outpatient clinics and patients’ homes.

The article mentions a recent study published in Health Affairs that looked at 11.8 million hospitalizations and found that patients who seek care at academic medical centers are less likely to die compared with patients who are treated at nonteaching hospitals. The study included several authors from Harvard T.H. Chan School of Public Health, including Laura Burke, an instructor of health policy and management, and Ashish Jha, senior associate dean for research translation and global strategy and director of the Harvard Global Health Institute.

While the study found that mortality rates were lower among all patients treated in teaching hospitals, the greatest difference was seen in relatively healthy patients.