Choosing a Hospital

Topic Overview

This may sound obvious, but the best time to choose a hospital is when you don't need one. That way you have the time to compare all the hospitals in your area and think about what your preferences are.

One local hospital may have an emergency room with a great reputation. But the hospital across town may have a better reputation for hip surgery. In other words, you might choose one hospital for emergencies and another hospital for other treatment.

So it's a good idea to do some research and find out what hospital is best for you, whether you're planning to have surgery, you have a serious health condition that could require future hospital treatment, you're planning to give birth, or you just want to be prepared.

What are the different types of hospitals?

There are many kinds of hospitals, large and small. Some are run by nonprofit organizations or charities. Some are public hospitals, which means they are funded by taxes. And some are run by corporations, whose investors get some of the profit.

Teaching hospitals

Hospitals that operate in partnership with medical schools are called teaching hospitals. In a teaching hospital, medical students, supervised by experienced doctors, improve their skills on patients, which some people might not like. But these hospitals also tend to have the newest treatments and equipment. And patients often benefit from the medical students, residents, and supervising doctors all working together to think about the best care.

Research hospitals

Some hospitals call themselves research hospitals. This means that many of the doctors who work there do scientific research in their fields of specialty and may even conduct clinical trials. Patients at this kind of hospital are often treated by doctors who are experts in their fields.

Specialized hospitals

A hospital may specialize in one type of patient. There are children's hospitals, psychiatric hospitals, cancer centers, and hospitals for the elderly, for example.

A trauma center is a hospital that is equipped to handle extremely serious types of injuries.

What services do hospitals provide?

Usually, the more beds a hospital has, the more services it provides. Most hospitals, for example, deliver babies. But not all hospitals have a special unit just for cancer patients or for patients with very bad burns.

Hospitals usually have a number of departments that treat patients, such as:

• Emergency department. This is where patients go (or are taken by ambulance) when they have serious problems and need immediate help.
• Maternity, where mothers-to-be are cared for during childbirth.
• Intensive care, or critical care. Patients in this department usually have life-threatening problems and need constant monitoring. Some hospitals have a separate pediatrics intensive care unit for children.
• Neonatal intensive care. This department specializes in caring for newborn babies who are ill or were born prematurely.
• Imaging. You may see this department if you need an X-ray, an MRI, a CT scan, or an ultrasound test.
• Surgery.This department contains the hospital's operating rooms and, usually, recovery rooms.

Larger hospitals may also have separate departments for certain specialties. For example, a hospital may have a cardiology unit, where heart patients are treated, or a special unit for people recovering from joint replacement surgery.

For certain treatments or surgeries, it can be important to go to a hospital with a lot of experience in those areas. Find out if any of the hospitals you're considering specialize in treating your condition.

How can you check the hospital's reputation?

Checking a hospital's reputation isn't as hard as you might think. There are four main sources of information:

1. Ask your doctor what he or she thinks.
2. If you have insurance, ask your carrier. Many insurance companies keep quality indicator records for doctors and facilities in the area.
3. Ask the hospital staff if they have patient surveys or internal quality check reports you can look at.
4. Check with health and government agencies who rate or report on the quality of hospitals. Your state's board of medicine or your insurance company can help you find these agencies. You can also see if the hospital is listed on one of these Internet sites:
   • Centers for Medicare & Medicaid Services (CMS), www.medicare.gov/hospitalcompare
   • The Joint Commission, www.qualitycheck.org
   • The Leapfrog Group, www.leapfroggroup.org

What else should you consider when choosing a hospital?

• Can your doctor practice there?
• If you have insurance, is the hospital covered by your plan?
• How often is the type of treatment or surgery you're having done at that hospital? Hospitals that do certain surgeries or treatments more often are likely to have better success rates. Your surgeon should be able to help you get this information. Or you can call the hospital and ask for it.

Other details

Aside from a hospital's reputation for quality and safety, the little things matter too. Comfort items can be especially important if you expect your hospital stay to be longer than a few days.

• Visit the hospital and ask for a tour. Call ahead and make an appointment for this.
• Ask to see a patient room or different types of patient rooms.
• Have a snack or a meal in the cafeteria. Chances are the same chefs are in charge of the patients' meals.

The hospital's location may matter to you too. Think about how far you will have to drive, especially if there will be follow-up visits. Will friends and family be able to visit easily?

Compare the visiting rules of the hospitals you're considering. Some hospitals are stricter about visiting hours than others. Will the hospital let a loved one stay in the room with you overnight?

What should you consider when choosing an emergency room?

In an emergency, it's usually best to go to the nearest emergency room (ER). But if there are several in your area, it's good to do some comparisons ahead of time.

Find out which ER has the shortest waiting times. You can usually find this out by calling the hospital and asking for its average patient wait in the ER.

Short waiting times in the ER are great, but quality of care is important. In some cases it may be worth the drive to go to the emergency room 20 miles away if they have better equipment-a trauma center, for example. Your doctor is a good source of information. Ask your doctor which ER he or she would take a family member to.

And nothing beats firsthand observation. Friends, neighbors, and coworkers who have been to the ER are good sources.