Shopping around for hospital services: a comparison of the United States and Canada.

<bold>Context: </bold>Historical comparisons indicate that US hospitals are more expensive than Canadian hospitals, but health care system reform might have changed the relative costs and timeliness of health care in the 2 countries.<bold>Objective: </bold>To estimate the price and convenience of selected hospital services in the United States and Canada for patients in 1997 had they paid out-of-pocket.<bold>Design: </bold>Cross-sectional telephone survey conducted May 1996 to April 1997.<bold>Participants: </bold>The 2 largest acute care general hospitals from every city in the United States and Canada with a population greater than 500000.<bold>Measures: </bold>Each hospital was telephoned and asked their price and waiting time for 7 services: magnetic resonance imaging of the head without gadolinium; a screening mammogram; a 12-lead electrocardiogram; a prothrombin time measurement; a session of hemodialysis; a screening colonoscopy; and a total knee replacement. Waiting times were measured in days until earliest appointment and charges were converted to American currency.<bold>Results: </bold>Overall, 48 US and 18 Canadian hospitals were surveyed. Median waiting times were significantly shorter in American hospitals for 4 services, particularly a magnetic resonance imaging of the head (3 days vs 150 days; P<.001). Median charges were significantly higher in American hospitals for 6 services, particularly for a total knee replacement ($26805 vs $10651; P<.001). Individual services showed no association between shorter waiting times and higher prices within each country, with the exception of a total knee replacement in the United States.<bold>Conclusion: </bold>US hospitals still provide higher prices and faster care than Canadian hospitals for patients who pay out-of-pocket. [ABSTRACT FROM AUTHOR]