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US report takes sheen off super-speciality hospitals

Super-specialty hospitals cherry-pick patients and exaggerate success, according to a US report.

world Updated: Oct 14, 2009 12:55 IST

Super-specialty hospitals cherry-pick patients and exaggerate success, according to a US report.

Although many specialised hospitals deliver better and faster services in cardiac care and other specialties, these hospitals cherry-pick patients to achieve these results, and average patients actually receive worse care, says the report.

Cherry picking is the act of pointing at isolated cases or data that seem to confirm a particular position, while ignoring a significant portion of related cases or data that may contradict that position.

The report, authored by Diwas KC, professor at Goizueta Business School, Emory University and Christian Terwiesch, professor at the Wharton School of Business, says that focused hospitals deliver faster services at higher levels of quality, as indicated by lower lengths of stay and reduced mortality rates.

They investigated the extent to which the superior operational outcome is driven by focused hospitals truly excelling in their operations or by focused hospitals simply selectively admitting patients who are easier to treat.

Their analysis shows that for randomly assigned patients, focused hospitals deliver a lower quality of care, as measured by a higher mortality rate. They also found that the average length of stay for a randomly assigned patient is longer at focused hospitals.

In other words, patient selectivity is an important driver of superior outcomes at focused hospitals. Furthermore, the authors show that average operational performance of existing hospitals deteriorates following the entry of a focused competitor, which attracts easy-to-treat patients.

Overall, they conclude that focused hospitals cherry-pick easy-to-treat patients at the expense of other, full-service hospitals in the region.

The report is being presented at the annual meeting of the Institute for Operations Research and Management Sciences at the San Diego Convention Centre.