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Limited Evidence To Connect Cost Of Health Care To Quality

Researchers need more evidence to determine the connection between quality and . The nation’s heath care costs are rising at an unsustainable rate, making it a priority to control costs. But there is uncertainty as to whether improvements in quality will cause costs to go up or down.

Researchers reviewed 61 published studies to determine the between health care quality and cost. Of 61 included studies, 21 reported a positive or mixed-positive between higher cost and quality; 18 reported a negative or mixed-negative between higher cost and quality; and 22 reported no difference, an indeterminate , or a mixed .

The limited evidence available suggests no clear relationship between cost and quality. The researchers conclude that more research is needed, focusing on what types of spending are most effective in improving quality and what types of spending are wasteful.

The authors of an accompanying editorial addressing efficient use of health care resources agree that more detailed and timely data is needed to make good medical, operational, and policy decisions. They call for provider organizations to be more transparent about the cost and price of services and for physicians to actively seek the information. They also suggest that those who fund research should support studies that evaluate cost and quality of interventions.


The Association Between Health Care Quality and Cost: A Systematic Review, , PhD; , MPH; and Ateev Mehrotra, MD, MPH, Ann Intern Med. 1 January 2013;158(1):27-34

American College of Physicians