The hospital amenity wars

Do private rooms, luxe bedding, massage therapy and WiFi mean you’re getting better hospital care?

Not necessarily. But for a growing number of consumers, hospital amenities (or lack thereof) seem to be an increasingly important factor in their choice of hospital.

An article last week in the New England Journal of Medicine describes this emerging trend, comparing it to the medical technology arms race that predominated in the 1970s and 1980s:

Now, yet another style of competition appears to be emerging, in which hospitals compete for patients directly, on the basis of amenities. Though amenities have long been relevant to hospitals’ competition, they seem to have increased in importance — perhaps because patients now have more say in selecting hospitals. And the hospital market is booming. National spending on hospitals exceeded $700 billion in 2008 and is growing rapidly.

The authors cite an example: the new $829 million Ronald Reagan UCLA Medical Center in Los Angeles, which opened in 2008 and boasts “private and family-friendly rooms, magnificant views, hotel-style room service for meals, massage therapy.” Patients obviously like it, because UCLA Medical Center has seen a 20 percent increase in the number of patients who say they would definitely recommend the facility to their family and friends.

This isn’t necessarily a bad trend. For too long, hospitals paid little attention to the extras that might help make a stay in the hospital more comfortable. If patients disliked sharing their room with a stranger or had a window with a view overlooking a brick wall, well, too bad. They were patients in a hospital, not guests at a luxury hotel. These days the thinking has changed, boosted by a fair amount of research showing that patients and families tend to feel less stressed and are better able to start the healing process when they’re in an environment that’s quieter, soothing and more home-like.

Here’s the question, though: Is the emphasis on amenities going too far, possibly at the expense of clinical quality?

When the authors of the NEJM article examined survey data, they found many patients valued nonclinical extras far more than the actual clinical care. In one survey, patients said they were willing to travel farther to a hospital that offered more amenities, even if the care was no better than at a hospital closer to home.

Hospital amenities seemed to be a factor in physician referrals as well, the study’s authors wrote:

Physicians said that when deciding where to refer patients, they placed considerable weight on the patient experience, in addition to considering the hospital’s technology, clinical facilities, and staff. Almost one third of general practitioners even said they would honor a patient’s request to be treated at a hospital that provided a superior nonclinical experience but care that was clinically inferior to that of other nearby hospitals.

It’s easy to criticize hospitals for investing in fancy amenities that don’t contribute directly to patient care. The fact is, however, that consumers want and even expect amenities. Hospitals that don’t offer these extras can place themselves at a serious competitive disadvantage. On some level, then, amenities and their role in the patient experience do matter.

As the NEJM article’s authors point out, hospital amenities also have implications for how hospitals are paid and how quality of care is measured. If payment becomes more value-based, we need to figure out what amenities are worth and how they should be weighed against cost and clinical excellence.

If the cost is higher and the quality of care is average, is it really a bargain for patients to choose a hospital on the basis of its hotel-style rooms? Or is the consumer better off selecting a hospital that’s perhaps a little less glitzy but consistently scores high on quality measures? Is it possible for hospitals to do well in all three areas – cost, quality and amenities – without being forced to make some tradeoffs?

What do readers think? Would you travel to receive care at a hospital that’s “nicer” even if your hometown hospital offers the same quality of clinical care? Would you choose a hospital with more amenities if you knew it would cost more? Leave your responses in the comment section below.

Image: lobby of the Four Seasons Hotel, downtown Miami. Courtesy of Wikimedia Commons.

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