The rate of mortality per dollar spent at Massachusetts General Hospital in Boston can be divided into four phases, with the current period marked by escalating costs, according to a report in the New England Journal of Medicine.
The authors studied mortality data from MGH from 1821 to 2010 to identify trends that may apply to acute-care hospitals in general. The authors identified four trends in mortality and cost at MGH. They controlled for the influence of one year's performance on the next, secular trends such as life expectancy at birth and significant events, such as wars, to derive the relationship between costs and mortality over time.
• 1821 to 1910: Random variation in mortality and flat costs. There was no significant relationship between cost and mortality.
• 1911 to 1960: Slight decreases in mortality and slight increases in cost. There was a weak relationship between cost and mortality that indicated for every $1,000 increase in cost, mortality was reduced by two deaths per 1,000 patients.
• 1961 to 2000: Steeper decrease in mortality and steeper increase in costs. There was a stronger relationship between cost and mortality. For every $1,000 increase in cost, mortality was reduced by 2.4 deaths per 1,000 patients.
• 2001 to 2010: Level mortality and increased costs. The authors said data was insufficient to determine the relationship between cost and mortality. However, they suggested the post-2000 era may have diminishing returns for mortality when costs increase, as the growth in costs outstrips the reduction in mortality.
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The authors studied mortality data from MGH from 1821 to 2010 to identify trends that may apply to acute-care hospitals in general. The authors identified four trends in mortality and cost at MGH. They controlled for the influence of one year's performance on the next, secular trends such as life expectancy at birth and significant events, such as wars, to derive the relationship between costs and mortality over time.
• 1821 to 1910: Random variation in mortality and flat costs. There was no significant relationship between cost and mortality.
• 1911 to 1960: Slight decreases in mortality and slight increases in cost. There was a weak relationship between cost and mortality that indicated for every $1,000 increase in cost, mortality was reduced by two deaths per 1,000 patients.
• 1961 to 2000: Steeper decrease in mortality and steeper increase in costs. There was a stronger relationship between cost and mortality. For every $1,000 increase in cost, mortality was reduced by 2.4 deaths per 1,000 patients.
• 2001 to 2010: Level mortality and increased costs. The authors said data was insufficient to determine the relationship between cost and mortality. However, they suggested the post-2000 era may have diminishing returns for mortality when costs increase, as the growth in costs outstrips the reduction in mortality.
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