Specialty Surgical Hospitals: Better Health Care through Innovation

Published November 3, 2004

With the 2004 campaign season now closed, we can reflect on how the politicians just didn’t realize–or wouldn’t admit–that government could do much to improve health care in the U.S. simply by getting out of the way and allowing the industry to heal itself through innovation.

Specialty surgical hospitals, which focus on a few areas of surgical practice such as heart surgery or orthopedic surgery, are a good example of innovation at work in the U.S. health care industry.

Compared to general hospitals, specialty surgical hospitals typically offer increased productivity, lower costs, and better patient outcomes. The key is specialization.

In specialty surgical hospitals, staff devote all of their energy to a few specific areas of care, allowing them to develop great skill and efficiency. Specialty hospitals are also more likely than general hospitals to have state-of-the-art equipment, ideally suited for the task at hand. An attorney focused on corporate tax law is likely to be more skilled in that field than an attorney with a general practice. Similarly, a surgeon focused on one or a few surgical procedures is likely to be more skilled in those procedures than a general surgeon.

Nurse-to-patient ratios are generally lower at specialty surgical hospitals than at general hospitals. Patients at specialty surgical hospitals typically see the same nurses throughout their stay, while at general hospitals a patient may see many different nurses during the course of their treatment. That can interfere with the continuity of care.

Compared to general hospitals, specialty surgical hospitals are better able to protect their patients against infections from other patients. The rate for nosocomial infections–infections that originate or occur in a hospital setting–is 10 to 20 times higher in general hospitals than in specialty surgical hospitals.

A major reason for the lower rate of infection is that specialty surgical hospitals typically focus on elective and pre-planned surgeries. If a patient who is scheduled for heart surgery shows up with a cold or the flu, the surgery can be rescheduled after the illness goes away. In specialty surgical hospitals, then, healthy patients are less likely to become infected by unhealthy patients. Their hospital stays are shorter–and their hospital bills lower–as a result.

A recent study comparing MedCath specialty surgical hospitals–a chain of 13 hospitals focused on cardiovascular surgery–to more than a thousand community and teaching hospitals that perform open-heart surgery found the average length of stay for MedCath patients was 25.6 percent shorter than at teaching hospitals. The mortality rate from open heart surgery was 16 percent lower at MedCath hospitals than at community hospitals.

General hospitals, which fear a loss of revenue to these superior rivals, have succeeded in getting Congress to prohibit temporarily any development of new specialty surgical hospitals. Congress should lift that moratorium and allow specialty surgical hospitals to continue to expand. They lower costs and provide high-quality care … and isn’t that what the politicians say they want to achieve?

Sean Parnell ([email protected]) is vice president – external affairs for The Heartland Institute, a national nonprofit research organization headquartered in Chicago.