NCPA - National Center for Policy Analysis

Bigger Hospitals Have Better Care

November 13, 2002

The Texas state-mandated Indicators of Impatient Care, released last month, used patients billing records to compare how well 351 hospitals handled 25 medical conditions or surgical procedures. The report was intended to give consumers a basis for selecting the best hospitals for their procedures, and consumers groups hope that it will have a profound effect on how hospitals are run.

Findings from Texas' first report card on hospital quality found:

  • Better care is found at larger, urban hospitals that perform procedures more often.
  • Some of the highest morality rates were found at smaller, community hospitals.

Over the years, scientific studies have detected lower mortality rates in larger hospitals, crediting the staff's ability to provide specialized care to acutely ill patients. Large hospitals often handle hundred of patients with the same critical conditions every years, while staffs of smaller hospitals may handle only dozens at best.

Recent medical studies suggest that smaller hospitals could improve their mortality risks by transferring severally ill patients as quickly as possible to larger hospitals. However, as advocates of smaller, regional hospitals point out, not all patients can be transferred or want to be transferred to a larger hospital.

Source: Sherry Jacobson, "Bigger Hospital May Mean Better Care," Dallas Morning News, November 5, 2002; "Indicators of Impatient Care in Texas Hospitals, 2000," Texas Health Care Information Council.


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