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Research studies claim specialty hospitals treat less ill patients ASHA dismisses findings, says independent studies more reliable

Ambulatory Surgery Reimbursement Update, July 26, 2005

Two new studies show that patients who underwent two types of cardiac procedures at specialty hospitals were less ill to begin with than those who underwent the procedures at general hospitals, with one study claiming specialty hospitals are treating wealthier patients as well.

The studies, performed by healthcare information firm Solucient and Yale professor Harlan M. Krumholz, MD, examined patients who underwent percutaneous coronary intervention or coronary-artery bypass grafting at both specialty and general hospitals. While both studies found specialty hospitals were treating healthier patients, Krumholz also concluded that the hospitals were also treating wealthier patients.

In response to the research, Jim Grant, ASHA president, says studies such as these are common and he takes the findings with a grain of salt. He says he looks at independent studies, such as those conducted by the Centers for Medicare & Medicaid Services (CMS) and the Medicare Payment Advisory Commission, as more reliable sources of information when comparing specialty and non-specialty hospitals.

"CMS looked at the entire data set of all specialty hospitals," Grant says. "They also looked at not just heart procedures, but also orthopedic procedures and other surgical procedures and found very substantial differences in quality, positive differences between specialty hospitals and non-specialty hospitals."

Solucient's research was published as a letter to the editor in the June 30 issue of the New England Journal of Medicine. Krumholz's study was published in the Journal Watch Cardiology on May 13.

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