Orthopaedic Specialty Hospitals Compared with General Hospitals: A Systematic Review of Demographic, Clinical, and Financial Parameters

Abstract

Background: Theoretically, orthopaedic specialty hospitals (OSHs) offer multiple advantages compared with general hospitals; however, their overall benefit is debated. This review aims to compare patient characteristics and outcomes between OSHs and general hospitals in the United States.

Methods: A systematic review was performed by querying PubMed and Embase from inception to April 2020 for articles comparing patient characteristics and clinical and economic outcomes between OSHs and general hospitals. Two researchers reviewed the articles according to prespecified criteria.

Results: The literature review yielded 3,715 articles, of which 19 were included. All articles were retrospective in nature. There were conflicting results with regard to preferential patient selection and profitability. OSHs generate a greater surgical volume, while decreasing operative time and length of stay, compared with general hospitals. Adverse outcomes have been reported to be less common at OSHs; however, this benefit is not supported by recent matched-cohort studies. Only 1 study evaluated patient satisfaction, and this study demonstrated improved satisfaction with OSHs.

Conclusions: The literature with regard to OSHs is limited by low-quality studies, often yielding inconsistent results. OSHs appear to offer some benefits; however, it is unclear if improved outcomes are due to better patient care or preferential patient selection.