GUIDE COMPARES HEALTH-CARE COSTS

The Missouri Department of Health has published its second annual Buyer's Guide, which compiles charges for 50 outpatient procedures offered at area hospitals and surgical centers.

But local hospital administrators warn that the guide shouldn't be the final word in consumer's crucial health-care choices.

"In matters of life and death, cheapest isn't always best," said John Fidler, president of St. Francis Medical Center.

But price increasingly plays into health-care decisions.

The price for removal of a gall bladder in Southeast Missouri, for example, ranges from $4,054 to $9,686.

A tonsillectomy could cost as little as $1,706 or as much as $3,585. The price for a treadmill stress test ranges from $120 to $404, and carpal tunnel release surgery costs from $850 to $3,395.

The publication shows that free-standing surgery centers are generally lower in price than hospitals on the outpatient procedures listed.

Fidler said that is to be expected, because hospitals have higher overhead, treat sicker patients and offer other services that free-standing centers don't offer.

The price of a single outpatient procedure is just one piece of the health-care cost pie, Fidler said, and decisions should be made by looking at a bigger picture.

"If you pull all the work out of hospitals to free-standing centers, it will increase the cost of care at hospitals," Fidler said.

He recommends patients check the number of procedures performed in addition to the price.

"A certain volume is needed to maintain proficiency," he said. "A higher level of volume indicates you are doing that procedure better."

Hospitals and ambulatory surgical centers throughout the state reported charges for outpatient procedures in 12 categories ranging from cataract removal to cardiac catheterization

Hospitals and centers in Cape Girardeau are Doctors' Park Surgery Inc., Missouri Surgery Center Inc., Southeast Missouri Hospital and St. Francis Medical Center.

Other regional centers are Mineral Area Regional Medical Center and Parkland Health Center in Farmington, Doctors Regional Medical Center and Lucy Lee Hospital in Poplar Bluff, and Arcadia Valley Hospital, Dexter Memorial Hospital, Madison Memorial Hospital, Missouri Delta Medical Center, Pemiscot Memorial Health Systems, Perry County Memorial Hospital, Reynolds County General Memorial Hospital, Ripley County Memorial Hospital and Twin Rivers Regional Medical Center.

The report found facilities with consistently low prices in the 1992-93 guide also were likely to have consistently low prices this year, while those that consistently had high prices last time were less likely to have high charges this year.

It also found that this region's facilities were the state's least likely to raise charges 5 percent or more.

Lucy Lee Hospital in Poplar Bluff had high charges in nine of 12 procedure groups.

Doctors' Park Surgery Center in Cape Girardeau had low charges in five of the 12 categories.

Ron Wittmer, president of Doctors' Park Surgery Inc., said the publication helps consumers make informed choices.

"In turn that is helping to hold down health-care costs overall," he said.

Patients are becoming more educated about their health care, he said. His center is receiving more and more phone calls from patients doing price comparisons.

The guide can be ordered from the Department of Health at P.O. Box 570, Jefferson City, Mo. 65102 for $3 per copy.

BUYER'S GUIDE FINDINGS

The highest facility charges are usually two to six times more than the lowest facility charges.

The highest charges for most procedures are $1,000 or more than the lowest charges.

The region's facilities were the least likely to raise charges 5 percent or more.

Most of the region's proprietary hospitals have higher charges.

No consistent relationship exists between a hospital's size and its charges.

This region had the most procedures where the maximum cost was $5,000 or more.

The most uniform procedure charges among facilities are MRI scans, CAT scans and other diagnostic procedures.

The widest range of procedure charges among facilities is in musculoskeletal operations and digestive-urinary procedures.