This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Revascularization  • Medical Practice, Other  • Cardiovascular System  • Surgery  • Cardiovascular/ Cardiothoracic Surgery  • Cardiovascular Disease/ Myocardial Infarction  • Cardiovascular Intervention  • Alert me on articles by topic  Social Bookmarking   What's this?

Too Much of a Good Thing?

Peter Cram, MD, MBA; Gary E. Rosenthal, MD

JAMA. 2007;297:998-999.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The emergence of specialty hospitals that focus on lucrative procedural aspects of medicine has generated a heated debate among policy makers^1-2 that largely involves 4 issues: patient selection (ie, "cherry-picking" of healthier and wealthier patients by specialty hospitals); quality of care in specialty and general hospitals; impact of specialty hospitals on the financial health of general hospitals; and influence of specialty hospitals on utilization and health care costs.

The debate intensified in 2003 with the passage of a temporary congressional moratorium (allowed to expire in 2005) on new specialty hospital construction. However, empirical data addressing the 4 issues remain limited. Consistent evidence suggests that specialty hospitals admit patients with lower acuity and fewer comorbidities than general hospitals.^3-4 Studies assessing quality have found that risk-adjusted rates of adverse outcomes in specialty hospitals are similar or somewhat lower (perhaps 10%-20%) compared with general hospitals.^5-6 . . . [Full Text of this Article]

Author Affiliations: Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, and Center for Research in the Implementation of Innovative Strategies for Practice (CRIISP), Iowa City Veterans Administration Medical Center, Iowa City, Iowa.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Opening of Specialty Cardiac Hospitals and Use of Coronary Revascularization in Medicare Beneficiaries
Brahmajee K. Nallamothu, Mary A. M. Rogers, Michael E. Chernew, Harlan M. Krumholz, Kim A. Eagle, and John D. Birkmeyer
JAMA. 2007;297(9):962-968.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Do Specialty Cardiac Hospitals Drive Regional Increases in Revascularization Rates?
Journal Watch Cardiology 2007;2007:1-1.
FULL TEXT