Better outcomes at physician-owned cardiac hospitals may be due to their lower patient acuity and higher procedural volumes than general hospitals, according to a study in Health Affairs.
Researchers studied patients who underwent percutaneous coronary interventions in general hospitals and cardiac hospitals in Texas from 2004 to 2007. Five of the six cardiac hospitals studied were partly physician-owned and one was fully owned by a hospital chain. The researchers found the risk-adjusted in-hospital mortality rate for patients treated at the cardiac hospitals was lower than the rate at general hospitals.
The cardiac hospitals treated fewer minority, uninsured and Medicaid patients than general hospitals. Four of the six cardiac hospitals performed more than double the annual number of PCIs than did general hospitals. After adjusting for patient severity and procedural volume, the mortality rates for cardiologists who owned specialty hospitals were not significantly different from those at general hospitals, suggesting that the unadjusted rates showing better outcomes at cardiac hospitals may be attributable to lower patient severity and higher PCI volume, according to the study.
In addition, mortality rates were higher when specialty physicians performed PCIs at a general hospital than when they performed the procedure at a cardiac hospital. The authors suggest physician-owned cardiac hospitals should report outcomes for all patients performed by their physicians, whether at the cardiac hospital or at a general hospital.
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Researchers studied patients who underwent percutaneous coronary interventions in general hospitals and cardiac hospitals in Texas from 2004 to 2007. Five of the six cardiac hospitals studied were partly physician-owned and one was fully owned by a hospital chain. The researchers found the risk-adjusted in-hospital mortality rate for patients treated at the cardiac hospitals was lower than the rate at general hospitals.
The cardiac hospitals treated fewer minority, uninsured and Medicaid patients than general hospitals. Four of the six cardiac hospitals performed more than double the annual number of PCIs than did general hospitals. After adjusting for patient severity and procedural volume, the mortality rates for cardiologists who owned specialty hospitals were not significantly different from those at general hospitals, suggesting that the unadjusted rates showing better outcomes at cardiac hospitals may be attributable to lower patient severity and higher PCI volume, according to the study.
In addition, mortality rates were higher when specialty physicians performed PCIs at a general hospital than when they performed the procedure at a cardiac hospital. The authors suggest physician-owned cardiac hospitals should report outcomes for all patients performed by their physicians, whether at the cardiac hospital or at a general hospital.
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