The sleek hospitals with the shiny machines aren’t always the best

More hospital and doctor services do not mean better outcomes or more positive experiences for patients. This is according to an analysis of patient experiences by the Dartmouth Institute in the current issue of Health Affairs.

Why? One possibility is that more health care can be less effective (and could harm you) if it is not well coordinated. Unlike other industries, hospitals and doctors haven’t been able to keep pace with information technology that would help doctors keep tabs on each others’ tests and medications. Doctors are trained to work independently, and they are usually paid to do more, not less. Hospitals struggle to impose guidelines and other processes on doctors. This can lead to uncoordinated care, putting patients at risk. Only rarely do doctors and hospitals tell us about the errors that this causes. We all seem to prefer the false “bliss” that our shared ignorance creates.

The methodologies used by Dartmouth and the federal government's patient hospital experience data aren't without their shortcomings. The effects observed by Dartmouth while significant, are small, but they are opposite to what most of us would assume. However, we feel the type of comparison Dartmouth makes in the Health Affairs piece is useful. Last July we published the Dartmouth Atlas data, urging consumers to consider the pros and cons of aggressive vs. conservative care. Use our Hospital Intensity tool to look up your hospital. We will be sharing our take on hospital experience in the coming months.

CR's Take: Buyer, beware. That sleek hospital with all the shiny machines for every body part may not be the best option. Instead, focus on hospitals with the latest safety features, including doctors who will coordinate your care with specialists and who will tell you about their successes, and their failures.

—John Santa, M.D., M.P.H., director, Consumer Reports Health Ratings Center

Read more from Dr. Santa on the importance of helping patients make well-informed health-care decisions. And tell us about your last hospital experience. Was it a positive one, or were put at risk or misinformed about your health care options?