WASHINGTON — For chronically ill patients in their last two years of life, Medicare spends an average of $59,379 in New Jersey but only $32,523 in North Dakota. The difference is primarily a result of patients getting more hospital care but not necessarily better care, according to a new report.
Researchers at Dartmouth Medical School say vast differences in spending patterns nationally point to why policymakers need to focus not just on the price of a particular service or on expanding health coverage to the uninsured.
The national average for spending on such chronically ill patients was $46,412. Colorado spends $42,595, with an average hospital stay of 14.31 days.
A large share of Medicare’s expenses — about $1 out of every $3 spent — is generated by enrollees with chronic conditions in their final two years of life. Researchers focused on the records of 4.7 million patients who died during 2001 to 2005 when compiling the Dartmouth Atlas of Health Care, which comes out every two years.
They found that the number of days those patients spent in the hospital varied greatly depending on where they lived. In New Jersey, patients in their last two years of life spent 27.1 days in the hospital, the highest state rate in the nation. At the other end, patients in Utah spent 11.6 days in the hospital.
Dr. Elliott Fisher, who led the study, said more days in the hospital didn’t necessarily lead to better outcomes. Those patients didn’t live longer, on average.
So what led patients to visit the hospital more often? The report says it’s the supply of beds — not how sick patients are — that is the key driver.
