Specialty hospitals engage in an exclusive care and treatment of patients. Any specialized category will fall under here; hence, some examples include women's hospitals, children's hospitals, psychiatric hospitals, and so forth. Proponents of these particular institutions will counter that they highly provide sufficient treatment and surgical procedures, in high-quality facilities; although, critics may argue that they pick certain patients and thus establishing abusive issues or posing as a financial threat. The controversy, therefore, goes on.
Introduction
Specialty Hospitals. Are they the cause or the symptom?
Hardly a new sensational controversy, some communities have grown used to hospitals specifically engaged in treating those mentally ill or those with traumas. Though, what almost all of us are used to seeing are the hospitality constructions dedicated to especially women and children. With a subset of skills and technological employment, specialty hospitals are able to provide their specialized services to their focused patients. Many opponents however are primarily concerned about those centered on cardiac, orthopedic, and/or surgical hospitals which led to another concern of "physician-ownership."
Specialty Hospitals vs. General Hospitals
While specialty hospitals supply focused patients with the upmost quality care and treatment in their facilities, general hospitals provide services such as diagnostics, treatment, and surgery for patients with an acute condition (some acute conditions could lead to a chronic condition, if left untreated). What that means is that the internal issue is sudden in onset, thus contrasting the definition of those with a chronic condition, or issues that are worsening over an extended period of time (i.e. osteoporosis, asthma). The difference actually relies on the nature of their services (do not confuse that with its quality): specialty hospitals admit patients of an illness of their specialty (which appears unethical given the context, beneath the second section of this introductory unit), while general hospitals admit and treat a broader range of conditions.
Concerns
Pros - The Proponents
Considering that specialty hospitals are enabled, and more likely, to have and provide high-quality treatments and resources.
Patient experiences are enhanced with high-quality care, since their facilities really complement the treatment being provided to the patient.
Though relatively small (in terms of representation in the healthcare industry and the national economic market), proponents are likely to argue that their representation in the industry overall may potentially lower the cost of healthcare.
Given the disproportionate amount of ill patients in general and specialty hospitals, mortality rates are significantly low for specialty hospitals. According to a conducted research in the Health Affairs Journal, their study had discovered that "for both moderate and severe patients," the ratio of patients dying on their hospital bed "or within thirty days of discharge" was low for specialty hospitals.
Because in most research articles referenced here provide an operational definition of what particular terms mean for the sake of studying a particular phenomenon, we will be using the discoveries/conclusions detailed in one of them (particularly the research article, Cardiac Revascularization in Specialty and General Hospitals) The following data includes:
Patients who had to undergo PCI Procedures (or Percutaneous Coronary Intervention - a nonsurgical procedure that involves improving the blood flow to the heart) in specialty hospitals were less likely than patients who underwent the same procedure in general hospitals to receive difficulties such as "chronic renal failure, diabetes with complications, or congestive heart failure". With the following reference, we can infer that, although significantly small, SH (specialty hospitals) indeed has a low mortality rate.
Cons - The Critics and Contenders
Specialty hospitals, to some (if not most) opponents, are considered attributions to operational discrepancies in regards to targeting patients of a specific need.
Favorable selection is prominent, in this case.
Though they represent a growing portion of both in the national market and in the healthcare industry, according to the U.S. General Accounting Office, specialty hospitals are able to tailor their treatment means and facilities, hence allowing physicians to have an increase productivity while being a part-time owners of the following establishment (which, in turn, allows them to gain financially). A growing concern arises - particularly from general hospitals - that because of this benefit, specialty hospitals are increasingly siphoning money off the most financial segments of the general hospitals.
Disproportionate amounts of ill patients: General hospitals contend that because specialty hospitals have enhanced and profitable services, and thus they have the advantage of engaging with less destructively ill patients than what general hospitals have to treat. It is then a given that general hospitals receive sicker and higher-cost patient populations - again, according to the U.S. General Accounting Office.
Because in most research articles referenced here provide an operational definition of what particular terms mean for the sake of studying a particular phenomenon, we will be using the discoveries/conclusions detailed in one of them (particularly the research article, Cardiac Revascularization in Specialty and General Hospitals) The following data includes:
Specialty CARDIAC Hospital patients were less severely ill than those in general hospitals, which was indicative of their statistical data. It was discussed in their last segment that, based on their findings, patients preferably seek much more professional care in specialty hospitals or, based on their admittance rates, prefer "healthier" ill patients. Therefore, it was inferred that because they "provide services with higher profit margins," patients are more likely to prefer their treatment to be under the wing of SH when it could be treated at a general hospital.
References:
Cram, Peter, et al. “Cardiac Revascularization in Specialty and General Hospitals.” New England Journal of Medicine, vol. 352, no. 14, 2005, pp. 1454–62. Crossref, doi:10.1056/nejmsa042325.
Greenwald, Leslie, et al. “Specialty Versus Community Hospitals: Referrals, Quality, And Community Benefits.” Health Affairs, vol. 25, no. 1, 2006, pp. 106–18. Crossref, doi:10.1377/hlthaff.25.1.106.
Guterman, Stuart. “Specialty Hospitals: A Problem Or A Symptom?” Health Affairs, vol. 25, no. 1, 2006, pp. 95–105. Crossref, doi:10.1377/hlthaff.25.1.95.
Gotbaum, Rachel. “Specialty Hospitals Pass House.” New Hampshire Public Radio, 21 Mar. 2012, www.nhpr.org/post/specialty-hospitals-pass-house-0#stream/0.
“Specialty Hospitals More Profitable than General Hospitals.” FierceHealthcare, 29 Mar. 2012, www.fiercehealthcare.com/healthcare/specialty-hospitals-more-profitable-than-general-hospitals.
U.S. Government Accountability Office. “Specialty Hospitals: Information on National Market Share, Physician Ownership, and Patients Served.” GAO, 15 May 2003, www.gao.gov/products/GAO-03-683R.
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