Written by Chris Isidore, CNN Contributors
How the federal government paid hospitals for care may have turned patients away from institutions closer to their homes.
An analysis of patient records from 2009 through 2016 found that the rate of patients visiting hospitals in more affluent areas of the country was 2.3 times as high as those in poorer ones, according to a study published this week in the journal Quality & Safety.
Chronic conditions in both higher- and lower-income areas were more likely to be treated at lower-rated hospitals, and patients were more likely to have to travel further distances to receive care.
There was little evidence of differences in the quality of care patients got at hospitals, the analysis showed.
“Our findings, while not surprising, highlight a potential gap between access to better outcomes across hospital regions,” wrote the authors of the study, which was led by Dr. Catherine Charles of Massachusetts General Hospital.
The study was based on data from the National Hospital Discharge Audit System, which looks at 20,000 cases at high-performing and low-performing hospitals across the country. More than 120,000 cases were from 2011 to 2015, and were released in June this year.
The research notes that the study is not a formal claim that higher-spending hospitals had “good care” or “bad care,” but the results do highlight a possible gap in the coverage of more health care.
“Our findings suggest that there may be an area of under-servicing that may exist across regions in the U.S.,” Charles and her colleagues wrote.
The researchers didn’t necessarily find a gap in safety or performance in hospitals, but they said they were concerned that funding may have been directed at hospitals that serve richer patients, and away from those that are more needed in poorer areas.
The study was not funded by any health organizations or government agency, and Charles stressed the results should not be interpreted as any sort of endorsement of quality hospitals or better care.
“While there may be variation in care on a state-by-state basis, we were not able to statistically demonstrate any differences in the quality of care, relative to low-performing hospitals,” she said in a statement.
“The data released today only captured patients admitted to a hospital under these surveillance programs.”
Although health reform programs have focused on coverage of patients’ medical needs, lower cost has been typically considered a given benefit in the program, Charles said.
“To limit any disparities would require a systemic change to the way safety measures are implemented,” she said.
The Federal Provider Relief Fund, which was launched in 2017 as part of the Affordable Care Act, allows hospitals to receive payments from the government when they can’t meet their actual budget expenses due to federal or state cuts.