The study examined nearly 37,000 hospitalizations from 1996 to 2003 who were admitted to emergency rooms in the state of Florida. Mr Doyle analyzed the patient data by ZIP code, age and even seasonality of visit to make sure that he was studying demographically similar tourists being treated throughout Florida.

On the contrary, some studies have shown that patients in higher-spending areas do not necessarily have a lower mortality rate than those in lower-spending areas. But other economists have found data suggesting that additional spending does make a difference.

Moreover, Mr Doyle notes, Florida has significant variation in how areas treat patients after heart attacks. “The higher-spending hospitals use more ICU services, and they have higher staff-to-patient ratios, so they use more labor,” Mr Doyle said. “And that's expensive.”

Overall, a 50 percent increase in what Mr Doyle calls a hospital's spending intensity allows it to reduce mortality rates due to heart problems to about 26 percent below the mean.

"There are smart ways to spend money and ineffective ways to spend money, and we're still trying to figure out which are which, as much as possible," Mr Doyle said.

Among other findings, Mr Doyle discovered that an increase of about $4,000 per patient in hospital expenditures led to a 1.4 percentage-point decrease in the mortality rate.

Robert Kaestner, an economist at the University of Illinois at Chicago, said: "I found it to be a very creative, careful study that addresses a very important health-policy question. It's reasonable to believe that the difference in outcomes he finds is not because the visitors systematically differ in terms of where they visit or get care. It's a very plausible finding, showing how more spending and use of resources is related to lower mortality."

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