Physician-owned single specialty hospitals may prod nearby hospitals to increase nurse staffing levels
Research Activities, October 2009
Single specialty hospitals (SSHs) limit their focus to providing one service, such as surgery, cardiac care, or orthopedics. In doing this, they claim to provide efficient, high-quality care. Opponents of physician-owned SSHs claim that they create unfair market competition by attracting profitable patients who otherwise would spend their money at a community hospital offering the same services. Community hospitals that compete with SSHs, especially surgical or orthopedic SSHs, may be more likely to increase their nursing staff compared with hospitals that do not compete with SSHs, according to a new study.
Community hospitals may increase their nursing staff to compete with the quality of care offered at SSHs, explain Kathleen Carey, Ph.D., M.A., and colleagues at the U.S. Department of Veterans Affairs and Boston University School of Public Health. They studied the effect SSHs had on nurse staffing levels in 10 States from 1997 to 2004, a period in which the number of SSHs consistently rose.
They found that the local market presence of an SSH was associated with 10.1 more registered nurses at a general hospital compared with a general hospital with no SSH competitor. This increase in nursing staff theoretically results in fewer adverse events, health care-associated infections, and pressure ulcers. However, more research is needed to determine if nursing levels affect these indicators of quality, the authors suggest. This study was funded in part by the Agency for Healthcare Research and Quality (HS16541).
See "Single specialty hospitals and nurse staffing patterns," by Dr. Carey, James F. Burgess Jr., Ph.D., M.A., and Gary J. Young, Ph.D., J.D., in the June 2009 Medical Care Research and Review 66(3), pp. 307-319.