Photo: BolistonHospitals may be more recession-proof than many other industries, but they are hardly immune. If you are running a hospital these days and want keep your beds full, what should you do: Try to raid your competitors for the best doctors available? Undertake an ad campaign that trumpets the excellence of your care? Or maybe just install wireless internet and spruce up the rooms?
According to a new working paper called “Hospitals as Hotels” by Dana Goldman and John A. Romley, both of RAND, that last option — improving the hospital’s patient amenities — might be the best investment. (Abstract is here, PDF is here.) As they summarize:
“Amenities such as good food, attentive staff, and pleasant surroundings may play an important role in hospital demand. We use a marketing survey to measure amenities at hospitals in greater Los Angeles and analyze the choice behavior of Medicare pneumonia patients in this market. We find that the mean valuation of amenities is positive and substantial. From the patient perspective, hospital quality therefore embodies amenities as well as clinical quality. We also find that a one-standard-deviation increase in amenities raises a hospital’s demand by 38.4 percent on average, whereas demand is substantially less responsive to clinical quality as measured by pneumonia mortality. These findings imply that hospitals may have an incentive to compete in amenities, with potentially important implications for welfare.”
I find this mildly disheartening but not very surprising. The hospital that my family and many friends use in New York has extraordinary medical personnel and great outcomes but facilities that leave quite a bit to be desired.
There is a constant mental struggle between acknowledging how good the care is while facing how unpleasant the surroundings can be. So far, we’ve stuck with it — but I can imagine a first-time patient walking in there and deciding, merely because of the lack of amenities, not to become a second-time patient.
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Not the best thing, but http://www.hospitalcompare.HHS.gov has some clinical quality data for some particular conditions that could be used to compare facilities. Also has some data on mortality rates adjusted for risk factors in the particular patient population.
Anyone who doesn’t think amenities matter, or should, should read The Experience Economy. People have gone from demanding the good, to demanding service, to now demanding an “experience” that is unique to a provider. Current economic situation aside, providing this experience for a customer becomes more important than providing lowest cost. Hospitals are extremely competitive and if that is what patients, or potential patients expect, that is what the next capital campaign will pay for. You would not BELIEVE the uber-posh birth tower our hospital just built. I know people who decided not to induce so they could wait the extra couple days for it to open. CRAZY.
I have to take issue with this oft-repeated contention that hospitals are more “recession-proof”. This is misinformation. Here’s a tip: when Americans don’t have jobs, they tend not to have health insurance. When they don’t have health insurance, they tend not to go to the doctor. We’ve already seen massive drops in the levels of routine Primary Care visits and elective surgeries. If an issue is not urgent, Americans are not getting it taken care of. Hospital, private doctors offices, and dentists are all suffering in this economic climate.
Agree with #11.
Amenities may matter for outcomes in some circumstances.
The story may not be true but I have heard that Denmark was in the practice of shipping some convalescing patients to a hotel in Majorca rather than keep them in a Danish hospital because the patients made a faster and better recovery at a lower cost in Majorca.
When my dad was alive, My mom loved to go to hospitals. In her mind, they were where she could be taken care and perhaps left alone. I don’t see it that way so much. Barring illness, people have to take care of themselves. But then how does one stay calm when kids are demanding and feeling a bit hopeless. the advice I have been giving myself–chill out.
Free beds? What free beds? At my public hospital we have more patients than we can handle and often run at a loss because these patients can’t afford the medical care we’re providing. We should be fixing the health system first before providing “amenities” to patients – personally, I’d rather see money go to purchasing flu shots than providing cookies (which are full of simple carbs, anyway).
I can’t think of a better argument against for-profit hospitals than this. What sort of health system views hospitals having fewer inpatients as a problem? Especially having fewer patients that are likely to get swayed by whether or not there’s a nice painting in the room.
If we’re talking something other than emergency care (where getting treatment quickly usually matters more than anything else), a rational patient would be most interested in issues like whether the hospital had a reputation for quality care in the specialty in question. In other words, which hospital would help them stay alive. That seems like a good standard to choose from to me.