NEJM: Policy makers scrutinize patient amenities

The value of patient amenities is an emerging conversation among healthcare policy makers, according to an editorial published Dec. 2 in the New England Journal of Medicine.

“Are amenities a valuable part of the hospital experience?” asked Dana P. Goldman, PhD, from the Leonard D. Schaffer Center for Health Policy and Economic at the University of Southern California, Los Angeles, and colleagues. “One could argue that they’re an important element of patient-centered care. If amenities create environments that patients, providers and staff members prefer, then providers and staff members may give better care and service in those environments and patients may have better health outcomes.”

The authors noted that a style of competition is emerging where hospitals compete for patients directly, on the basis of amenities. Researching to determine where Medicare patients with pneumonia had received care in greater Los Angeles between 2000 and 2004, the authors drew on a market survey’s data about amenities and used pneumonia-related mortality as a measure of clinical quality.

“We found that patient often did not choose the closest hospital; they were willing to travel to get care at an alternative hospital. But their choices were only moderately correlated with the hospitals’ risk-adjusted rates of death.”

Amenities matter because patients do not understand clinical quality, Goldman and colleagues asserted. “Consumers may be making choices on the basis of amenities because they are easier to understand.

“At present, our healthcare seems conflicted about the patient experience,” continued the authors. “Under healthcare reform, Medicare will begin paying hospitals on the basis of value…On the other hand, process measures of quality have also been proposed.

“As healthcare reform moves forward, we need to decide whether amenities are a valuable part of the hospital experience,” they concluded. “If they are, we must account for them in the ways that we measure overall quality, prices and productivity.”

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