PDF(Pubmed)
Abstract：
BACKGROUND: The federal health care price transparency regulation from 2019 is aimed at bending the health care cost curve by increasing the availability of hospital pricing information for the public.
OBJECTIVE: This study aims to examine the associations between publicly reported diagnosis-related group chargemaster prices on the internet and quality measures, process indicators, and patient-reported experience measures.
METHODS: In this cross-sectional study, we collected and analyzed a random 5.02% (212/4221) stratified sample of US hospital prices in 2019 using descriptive statistics and multivariate analysis.
RESULTS: We found extreme price variation in shoppable services and significantly greater price variation for medical versus surgical services (P=.006). In addition, we found that quality indicators were positively associated with standard charges, such as mortality (β=.929; P<.001) and readmissions (β=.514; P<.001). Other quality indicators, such as the effectiveness of care (β=-.919; P<.001), efficient use of medical imaging (β=-.458; P=.001), and patient recommendation scores (β=-.414; P<.001), were negatively associated with standard charges.
CONCLUSIONS: We found that hospital chargemasters display wide variations in prices for medical services and procedures and match variations in quality measures. Further work is required to investigate 100% of US hospital prices posted publicly on the internet and their relationship with quality measures.
OBJECTIVE: This study aims to examine the associations between publicly reported diagnosis-related group chargemaster prices on the internet and quality measures, process indicators, and patient-reported experience measures.
METHODS: In this cross-sectional study, we collected and analyzed a random 5.02% (212/4221) stratified sample of US hospital prices in 2019 using descriptive statistics and multivariate analysis.
RESULTS: We found extreme price variation in shoppable services and significantly greater price variation for medical versus surgical services (P=.006). In addition, we found that quality indicators were positively associated with standard charges, such as mortality (β=.929; P<.001) and readmissions (β=.514; P<.001). Other quality indicators, such as the effectiveness of care (β=-.919; P<.001), efficient use of medical imaging (β=-.458; P=.001), and patient recommendation scores (β=-.414; P<.001), were negatively associated with standard charges.
CONCLUSIONS: We found that hospital chargemasters display wide variations in prices for medical services and procedures and match variations in quality measures. Further work is required to investigate 100% of US hospital prices posted publicly on the internet and their relationship with quality measures.
摘要：
背景：从2019年开始的联邦医疗保健价格透明度法规旨在通过增加公众对医院定价信息的可获得性来弯曲医疗保健成本曲线。
目的：本研究旨在研究互联网上公开报告的与诊断相关的团体收费标准价格与质量指标之间的关联，过程指标，和患者报告的经验措施。
方法：在这项横断面研究中，我们收集并分析了2019年美国医院价格的5.02%(212/4221)的随机分层样本,采用描述性统计和多变量分析.
结果：我们发现可购物服务的价格差异极大，医疗服务与外科服务的价格差异明显更大（P=.006）。此外,我们发现质量指标与标准费用呈正相关，如死亡率(β=.929；P<.001)和再入院(β=.514；P<.001)。其他质量指标,例如护理的有效性(β=-.919；P<.001)，医学影像的有效利用(β=-.458；P=.001)，和患者推荐评分（β=-.414；P<.001），与标准电荷负相关。
结论：我们发现，医院主管在医疗服务和程序的价格上表现出很大的差异，并且与质量措施的差异相匹配。需要进一步的工作来调查100％公开发布在互联网上的美国医院价格及其与质量措施的关系。
目的：本研究旨在研究互联网上公开报告的与诊断相关的团体收费标准价格与质量指标之间的关联，过程指标，和患者报告的经验措施。
方法：在这项横断面研究中，我们收集并分析了2019年美国医院价格的5.02%(212/4221)的随机分层样本,采用描述性统计和多变量分析.
结果：我们发现可购物服务的价格差异极大，医疗服务与外科服务的价格差异明显更大（P=.006）。此外,我们发现质量指标与标准费用呈正相关，如死亡率(β=.929；P<.001)和再入院(β=.514；P<.001)。其他质量指标,例如护理的有效性(β=-.919；P<.001)，医学影像的有效利用(β=-.458；P=.001)，和患者推荐评分（β=-.414；P<.001），与标准电荷负相关。
结论：我们发现，医院主管在医疗服务和程序的价格上表现出很大的差异，并且与质量措施的差异相匹配。需要进一步的工作来调查100％公开发布在互联网上的美国医院价格及其与质量措施的关系。
