Specialty hospitals in Pennsylvania continue to proliferate, agency says

General hospitals still control the vast majority of business.
HARRISBURG (AP) -- The proliferation of specialty hospitals, such as outpatient surgery centers, has continued steadily in Pennsylvania, with a financial performance that appeared mixed, but mostly positive, a state agency said.
In a report being released last week, the Pennsylvania Health Care Cost Containment Council charted solid gains in the use and financial health of the state's outpatient surgery centers and rehabilitation care centers, although the latter group was helped significantly by an increase in Medicare reimbursement rates.
Psychiatric care facilities, however, lost money as annual patient revenue remained below that of a decade ago.
Long-term acute care hospitals, which rely on Medicare for two-thirds of revenue, substantially cut losses, but still didn't register an overall profit.
The figures were based on the fiscal year ending in June 2003, or an institution's fiscal year that ended before that.
Biggest share of business
General hospitals still control the vast majority of business. For instance, the state's 185 general hospitals reported 32.9 million outpatient visits -- including things such as X-rays, laboratory tests, and pre- or postoperative checkups -- vs. 3.4 million visits to the state's 176 specialty hospitals operating during the period.
In addition, specialty units often open up inside general hospitals, helping the units avoid expensive startup costs associated with building a stand-alone facility. For example, 67 of the state's general hospitals had rehabilitation centers during the 2003 fiscal year that counted as part of the hospital's operations, and not separate.
Still, the period showed the number of the specialty hospitals growing steadily.
Even since the June 2003 end of the financial reporting period, specialty care centers have continued to open, including an additional 48 outpatient surgery centers through May for a total of 161.
"The delivery system is changing," said council spokesman Joe Martin. "It's becoming more process-oriented and less focused on the inpatient setting."
Outpatient procedures
And nearly 20 percent of outpatient surgical and diagnostic procedures were performed at outpatient centers instead of at general hospitals during the period, up from 9 percent four years ago, the report said.
"In the grand universe it's a small chunk" of the total outpatient visits, Martin said. "But it's an important subset and a rapidly growing one."
In addition, patient stays at the specialty hospitals have largely shortened, most noticeably at rehabilitation centers, according to the report.
At rehabilitation centers, the length of stay dropped from about 18 days in 1994 to under 12 in 2003.
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