Story highlights Rich Lesser and Barry Rosenberg: Most of the health care debate focuses on access and costs

But the real issue is quality of care, which varies wildly from hospital to hospital

If hospitals are measured and assessed more regularly, it will increase accountability and decrease long term healthcare costs

Rich Lesser is president and CEO of The Boston Consulting Group. Barry Rosenberg, MD, is a partner in BCG's Health Care practice and lead author of the study on which this article is based. Conducted in cooperation with Ariadne Labs, Harvard T.H. Chan School of Public Health, Alerion Institute, Johns Hopkins School of Medicine, University of Michigan Medical School and University of Rochester Department of Public Health, the study was published December 14 in the peer-reviewed scientific journal PLOS ONE. The opinions expressed in this commentary are those of the authors.

(CNN) As Congress and the Trump administration debate the future of America's health care system, they should go beyond the issues of access and cost and recognize an equally important priority: that patients come first, so health reform should also focus on quality of care.

Seen statistically in hospitalized patients' complication and mortality rates, and in the percentages of individuals with chronic diseases who are kept out of the hospital with effective preventative care, these quality "outcomes" are the overlooked elephant in the room for health reform.

Rich Lesser

Barry Rosenberg

We recently analyzed 22 million hospital admissions across the country, examining two dozen common conditions, including such widespread illnesses as heart disease, diabetes and post-operative infections. What we found were surprisingly large variations between the best- and worst-performing hospitals.

Patients in the worst-performing hospitals -- those in the bottom 10% -- were three times more likely to die and 13 times more likely to experience complications than those in the top-performing hospitals. The probability of dying in the hospital after a heart attack or stroke was more than twice as high in low-performing hospitals as in high-performing ones. And patients in low-performing hospitals were nearly 20 times more likely to experience IV line infections and more than three times more likely to contract post-operative sepsis infections than in high-performing hospitals.

It would not be overly dramatic to characterize some of the outcome differences as alarming, including significant differences among hospitals within the same metropolitan area.

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