If you go to the hospital for a surgical procedure, like a hip or knee replacement, you should feel at ease knowing that you are in good hands. Sadly, that is not always the case. A recent article by US News shows that the closest hospital might not always be the best hospital, especially if the closest hospital is smaller and less trained in surgical procedures. But how are you supposed to know whether your closest hospital is trained to do your procedure or not?
According to the Wall Street Journal, the answer is not so simple. Small rural hospitals, with no more than 25 beds, are called critical-access hospitals. These hospitals are given financial incentives under Medicare to offer surgical procedures like hip or knee replacements. The rate at which these procedures were covered at smaller hospitals by Medicare rose 42% from 2008 to 2013. While it seems like a good idea to offer incentives to make these procedures more readily available, many of these hospitals are not staffed with doctors who can handle these complex surgeries or complications involved with them. A US News Analysis showed that among critical-access hospitals, the average knee replacement preformed at such hospitals was only 3.7 a year. The average hip replacement was 3.3.
Mortality rates for joint replacement procedures at critical-access hospitals are 9 per 1,000 as opposed to general hospitals where they are 5 in 1,000. The financial incentives offered by Medicare makes it more appealing for critical-access hospitals to offer them. Knee-replacement patients at critical-access hospitals had a 25 percent higher rate of re-admission because of post-discharge complications. Hip-replacement patients faced a 77 percent higher risk of death and a 25 percent higher risk of re-admission. Studies show that as doctors gain experience the mortality rates decrease, but until then mortality rates have been holding steady with the patients having to face the learning curve.
If you are expecting to have a major surgery, do your research. Make sure that the hospital procedure is scheduled at is experienced in performing your surgery. For heart surgeries you would want your hospital to be performing 200-300 cases a year. Research your surgeon. Make sure they have experience in at least 100 surgeries. Prepare a list of questions to ask your doctor about the hospital where your surgery will be held. Make sure you are prepared so that you are not caught on the learning curve of smaller hospitals.