Hospital quality and intensity of spending: is there an association?

Health Aff (Millwood). Jul-Aug 2009;28(4):w566-72. doi: 10.1377/hlthaff.28.4.w566. Epub 2009 May 21.


Numerous studies in the United States have examined the association between quality and spending at the regional level. In this paper we evaluate this relationship at the level of individual hospitals, which are a more natural unit of analysis for reporting on and improving accountability. For all of the quality indicators studied, the association with spending is either nil or negative. The absence of positive correlations suggests that some institutions achieve exemplary performance on quality measures in settings that feature lower intensity of care. This finding highlights the need for reporting information on both quality and spending.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Economics, Hospital*
  • Hospital Costs
  • Hospitals / standards*
  • Quality Indicators, Health Care*
  • United States