I'd pay more for quality. If I knew hospital X is better at hip replacement I'd pay extra to go there. Of course how much extra I'm not sure, and I'm also not sure how you compare hip replacement quality like that.
It is only emergency rooms where I don't get a choice - if you need an emergency room close is important.
> It is only emergency rooms where I don't get a choice - if you need an emergency room close is important.
i feel like the folks on here peddling this line have not ever spent any time watching who comes through an ER.
most of the people who go into an ER aren't dying, or screaming in pain. they've just got a problem that can't wait until urgent care opens up again in the morning. or they need something done that urgent cares aren't equipped to do (fancier diagnostic equipment; whatever). they've got plenty of time to consult with a hypothetical "find a cheap/good ER near me" app.
I think lots of people say "ER" for "ED" Emergency Department became the most common term about a decade ago and Emergency Room faded from building guides and hospital documents.
Either way most don’t have trauma centers, in SF I think only SF General is the only level 1 trauma center although some of the people also rotate through UCSF’s ED.
If you're concerned about hip replacement quality, you should care more about the surgeon than the hospital. Check out the ProPublica Surgeon Scorecard: https://projects.propublica.org/surgeons/
Unfortunately, under the current system, price and quality of care are relatively uncorrelated. Which makes sense as we learn how arbitrary pricing is.
But as I understand how medical billing actually works, if only a single patient uses an MRI machine in a year, they would pass on the entirety of the cost to the single patient. But a hospital that uses the MRI constantly spreads the cost across all patients. In the latter hospital, they would also have better outcomes since they have more experience and specialization in the procedure.
This is also the opposite of how it would work in a market-based industry. In an auto-shop, I know how much I can charge for any service, and before buying equipment and personnel to expand my services, I determine if it is worthwhile to invest the capital.
You compare hip replacement quality by asking what the center's/surgeons complication rate is. How many are they having to go back and redo, a revision as they call it. It would be nice if these rates were publicly accessible in a easy to search database. As it stands now, hospitals market themselves on size, volume, and fancy buildings all of which don't mean much compared to complication rates.
> I'd pay more for quality. If I knew hospital X is better at hip replacement I'd pay extra to go there.
Recently, HSAs and transparent prices were proposed by a Marketwatch article on HN.
But, assuming you have a average America "Max Out Of Pocket", price transparency over this amount doesn't have the intended effect or perhaps, as you point out, the opposite effect.
There are lots of ways to measure outcomes. First, you can look at institutional metrics like nosocomial infection rates. Second, you can look at metrics for that procedure like rate of surgery revision. Many of these kinds of metrics exist, but are never exposed to the public.
It is only emergency rooms where I don't get a choice - if you need an emergency room close is important.