These deficiencies limit the analyst's ability to compare different CEA studies. A basic problem with CEAs is the use of charge data as a proxy for cost data. This is based on the assumption that analyzing costs will improve the delivery of health care. Costs, however, have very little to do with the quality of health care one receives, much less what is charged for health care services. For example, what one hospital or provider charges for a particular procedure may not necessarily be what another charges.
Geographic variations exist.
More specifically, how much hospitals or providers charge for a particular procedure is no reflection of the quality of the procedure performed. There is no guarantee that if a patient pays more, the procedure will be done better, nor does paying less mean the procedure was not done correctly. In addition, what third-party payers are willing to pay providers may only be a fraction of what they charge. So one can see why there is a critical need to find better ways to measure cost before CEAs can be used by health policy-makers for making health care decisions. Surprisingly, quality of care is not a major determinant in a patient's decision to initiate a malpractice claim.