The Henry Ford of Heart Surgery: a Factory Model for Hospitals
online.wsj.com
online.wsj.com
There is a growing move to go to specialized hospitals like Heart Hospitals, Surgery Centers or stand alone OB centers in the US, because they are big revenue generators for the owners of those specialty hospitals. But, while I'm sure quality goes up at dedicated heart hospitals, it causes problems on the macro scale, because those specialized hospitals drain patients with private insurance that would otherwise be subsidizing patients without insurance at a general hospital.
If you read between the lines of the article, what they don't say is they are charging cash up front for many of those surgeries. Families with children needing heart surgery that don't have insurance are forced to either pay cash or their child likely dies an early death. It sounds like the are actually turning patients away that don't have the money to pay for their surgery. You can't do that in the US.
Hard to argue too much, it sounds like they do more for better and cheaper, which is a compelling combination.
"Dr. Shetty's success rates appear to be as good as those of many hospitals abroad. Narayana Hrudayalaya reports a 1.4% mortality rate within 30 days of coronary artery bypass graft surgery, one of the most common procedures, compared with an average of 1.9% in the U.S. in 2008, according to data gathered by the Chicago-based Society of Thoracic Surgeons [...] Dr. Lewin believes Dr. Shetty's success rates would look even better if he adjusted for risk, because his patients often lack access to even basic health care and suffer from more advanced cardiac disease when they finally come in for surgery."
Not at all. The factory model produces significant savings in processes without anything like universal coverage.
For example, the factory model produces those benefits for for IC manufacture, automobiles, clothing, printing, agriculture, etc.
The argument however, that we couldn't take advantage of things like this in this country in part because we didn't have universal coverage, was.
It appears you may have entirely misinterpreted my post.
Whatever.
> The argument however, that we couldn't take advantage of things like this in this country in part because we didn't have universal coverage, was.
Except that that's not true. As other folks have pointed out, we're starting to develop "heart surgery" factories and the like. Those folks also pointed out that some mandates that approximate universal coverage (a hospital has to take all comers) actually interfere with the development of factories because factories specialize.
Note that requiring that something be open to everyone is an obstacle.
At only $2000 (or even $5000), and with better outcomes, I'm not sure why anyone who needs open-heart surgery isn't heading to this facility. Even factoring in transit costs, and paying out of one's own pocket, it's probably less than a 10% or 20% copay on a $50,000 open-heart surgury done locally.
It does sound as if real competition is finally coming to surgical medicine.
"Health care needs process innovation, not product innovation. You can't do one big thing and reduce the price, we have to do 1,000 small things." Dr. Devi Shetty
Jack Lewin, chief executive of the American College of Cardiology, who visited Dr. Shetty's hospital earlier this year as a guest lecturer, says Dr. Shetty has used high volumes to improve quality. For one thing, some studies show quality rises at hospitals that perform more surgeries for the simple reason that doctors are getting more experience. And at Narayana, says Dr. Lewin, the large number of patients allows individual doctors to focus on one or two specific types of cardiac surgeries.
The only question is how to replicate this model in the United States in the face of tremedeous political obstacles. (The AMA cartel, almost certainly lot of paperworks and complicated rules, the FDA, etc)