By Tom Keppeler, Shoulder1 Staff
The hospital a patient goes to may have a direct impact on the quality of care he or she receives. In fact, according to a recent study, there is a great difference in that area between an elite group of top hospitals and the rest of the field.
The study, done by the HCIA-Sachs Institute, examined three types of orthopedic hospitals: those with orthopedic residencies, teaching hospitals, and community hospitals. The institutions HCIA-Sachs named as "best orthopedic hospitals" had about 30 percent fewer complications, less-expensive care (by about $200) and about one-quarter day less hospital stay. The Human Motion Institute, an organization that works with client hospitals to improve their orthopedic performance, sponsored the study. HCIA-Sachs' study is based on analysis of more than 700,000 Medicare cases of total knee replacement, total hip replacement, partial hip replacement, and intertrochanteric fracture.
"This is a way of letting communities know that there are good hospitals all over," says Jean Chenoweth, executive director of the institute and the study's director. "Also, by setting a benchmark, it encourages hospitals everywhere to adopt the best standard of care."
The study also suggests that hospitals with the largest orthopedic programs—and those that are growing fastest—have lower mortality and complication rates than their peers. The top hospitals also tended to handle the largest number of patients. In addition, the benchmark hospitals tend to send more people home upon discharge rather than nursing facilities. The study also found an interesting side note: that women are considerably more likely to remain in nursing care after surgery than men. Study organizers attribute the difference to the fact that women tend to outlive men, and are therefore less likely to have a caregiver at home later in life.
The top hospitals also treat a greater volume of patients and tend to more-complicated ailments with less complications, Chenoweth says.
Chenoweth says the study aims to set a higher benchmark for hospitals to follow. By demonstrating what the best hospitals are doing right, she says, it may encourage others to follow suit, thereby encouraging hospitals everywhere to improve. "Anytime you shine a light on a specific area, you will be able to find hospitals that set the benchmarks, and you will see great deviation between them and the rest of the field," Chenoweth says.
For now, however, patients may find themselves paying lower costs and spending less time in the hospital if they have their knee or hip surgery performed at one of the top hospitals, the study suggests.