Hospital Resources are Associated with Value-Based Surgical Performance

Abstract Background We have previously shown that inferior outcomes at safety-net hospitals are largely dependent on hospital factors. We hypothesized that hospitals providing “high value” care (low cost and better outcomes) would have advantages in human and financial resources. Methods The University HealthSystems Consortium Clinical Database and the American Hospital Association Annual Survey were used to examine hospitals performing 8 complex surgical procedures from 2009-2013. Hospitals in the lowest quartiles of both mortality rate and cost were characterized as high value (n=45), while those in the highest quartiles of both cost and mortality were low value (n=45). Hospital size, staffing, and financial characteristics were compared between these two groups. Results On average, high value hospitals had lower proportions of Medicaid patient days (17% vs 30%; p