LOS ANGELES – From hotel-style room service to massage therapy to magnificent views, hospitals are increasingly touting their luxury services in a bid to gain market share, especially in competitive urban markets, according to an article published in the New England Journal of Medicine.

The article raises questions about the role of amenities in hospital care – namely, how one decides to value the patient experience can have a significant effect on healthcare costs.

"Though amenities have long been relevant to hospital competition, they seem to have increased in importance – perhaps because patients now have more say in selecting hospitals," said John Romley, an economist with the Schaeffer Center for Health Policy and Economics at University of Southern California and research assistant professor in the USC School of Policy, Planning and Development.

According to some studies, patients are placing more value on the non-clinical experience than on measures of clinical quality, such as a hospital's risk-adjusted mortality rate.

In the New England Journal of Medicine, the authors cite their own research showing that Medicare patients often don't choose the hospital nearest to them. They are willing to travel, and not necessarily for better clinical care, – even in cases involving heart attack, where risk of death should be an overriding concern.

The proportion of patients who received care at a given hospital was strongly linked to the quality of amenities. Improved perks also have a significant effect on hospital volume, the authors concluded.

"On a societal level, the value of amenities is important because our healthcare system currently pays for them," said lead author Dana Goldman, director of the Schaeffer Center at USC and Norman Topping Chairman in Medicine and Public Policy at the USC School of Policy, Planning and Development. "A hospital seeking to strengthen its financial position might view investment in amenities as a sound strategy to attract patients. The question is, however, what effect such a strategy might have on patients' outcomes as well as on overall healthcare costs."

The researchers note that if amenities create environments that patients and providers prefer, the result may be better treatment and improved health outcomes. Accounting for patient experience can either help determine whether amenities are necessary to better performance or prompt hospitals to shift their focus entirely to clinical quality.

"As healthcare reform moves forward, we need to decide whether amenities are a valuable part of the hospital experience," Romley said. "If they are, policymakers should include them in the measures for overall quality, prices and productivity."