A Canadian study in JAMA linked better patient care and lower readmissions to Ontario hospitals with higher spending. Such hospitals also tended to have more specialized services, more experienced or specialized physicians and higher nurse staffing ratios. Physicians from Harvard School of Public Health wrote in an accompanying article that the relationship between cost and quality in the U.S. depends on how the money is spent and noted some physicians and hospitals deemed expensive spend more on direct patient care that results in better outcomes.

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