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Do specialty heart hospitals drive up heart care use? Study suggests the answer is yes

ANN ARBOR, Mich. Across the country, states are embroiled in a debate over "specialty hospitals" physician-owned hospitals that focus on a single disease process such as heart care or orthopedics. The debate has intensified ever since a federal government moratorium on opening new specialty hospitals expired last year.

Now, a new study reveals more about the effect that new "heart" hospitals might have on heart care use in their local area. The data differ from previous findings which suggested an uncertain relationship between heart hospitals and heart care use.

Specifically, the study, which was performed in Medicare beneficiaries 65 years or older, shows that the opening of a new specialty cardiac hospital is associated with a regional rise in heart procedures to open clogged arteries such as bypass surgery and angioplasties. The rise was twice as great as the rise that occurred in regions where an existing general hospital added heart services, or where no new heart care facilities opened.

And while the study wasn't designed to look at whether each heart procedure was medically warranted, the authors note that the launch of a specialty hospital appears to particularly drive up the use of angioplasty in patients without heart attacks: a group where the procedure's long-term clinical benefit may be less clear.

The findings, published in the March 7 issue of the Journal of the American Medical Association, come from a team from the University of Michigan Cardiovascular Center, the VA Ann Arbor Healthcare System and the Michigan Surgical Collaborative for Outcomes Research and Evaluation, and their colleagues from Harvard University and Yale University.

"This is the first study to show that specialty cardiac hospitals increased the use of these procedures in the hospital markets where they opened, compared with regions where existing hospitals added heart care services or regions where there was no change in h
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
6-Mar-2007


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