First published on on June 11, 2014
In response to the question: How should patients use the increasing amount of data available on prices and quality of care at competing hospitals?

It may seem paradoxical at first, but the more complicated the medical problem, the less important are price and quality data. There are lies, damn lies, and data.

First, price. If one’s back is to the medical wall, no sane person is going to skimp when extra expenditures will buy a chance at a better outcome. Price-consciousness should, therefore, be reserved for commodity medical services.

Ideally, quality data would tell us where to go for that chance at a better outcome, but, here, too, the data are only useful for commodity services delivered to a broad, homogeneous population.

For example, Johns Hopkins, where I spent many years, is never going to have the quality performance numbers that good community hospitals will, because half of Hopkins’ patients come from long distances as very difficult cases, and because the other half are from its impoverished east Baltimore neighborhood. These challenging populations inevitably drag down quality scores, which then compare unfavorably to hospitals serving healthier patients. However, one’s chances at Hopkins for many serious or unusual conditions are going to be better than in a community hospital.

Thus, before making decisions based on data comparisons, be sure you understand the limits of the data, and how they really apply to you.

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