Reasons to Have Surgery at a Tertiary Care Center

It is estimated that U.S. citizens undergo an average of 9.2 surgeries in their lifetimes, comprising of 3.41 inpatient, 2.56 outpatient, and 3.20 non-OR procedures (1). Each setting is suited for different ranges of clinical contexts. While the overall trend is more and more procedures in outpatient settings such as surgery centers, for many people, there are still reasons to have surgery at a tertiary care center.

 

Tertiary care centers are large hospitals that contain specialized physicians and equipment for the delivery of complex care. Patients who visit tertiary care centers have likely already received primary care from their PCP, and potentially secondary care from specialists such as dermatologists, cardiologists, and oncologists as well (2). One of the main reasons to have surgery at a tertiary care center is if other facilities lack essential or valuable resources for the specific case.

 

These large hospitals are often affiliated with nearby universities. Otherwise referred to as teaching hospitals, these facilities have been shown to offer statistically higher levels of clinical performance as shown by lower mortality rates (3).

 

Housing a variety of specialists and sub-specialists, tertiary care centers foster a collaborative environment which results in comprehensive treatment plans. This makes them an ideal choice for patients who will be undergoing more complex surgeries, such as spinal surgery, organ transplants, and brain surgery. They are often furnished with cutting-edge technologies, including surgical robots, wearable health monitoring devices, advanced 3-D printers, and more, that can improve treatment (4,5). Should any complications arise, these care centers have no shortage of medical equipment and professionals who are available to assist. This includes access to extensive post-operative monitoring and care.

 

Tertiary care centers are also a great choice for patients in need of a varied care team composed of different specialists during the course of their treatment. For example, for breast cancer patients anticipating receiving chemotherapy who also may elect to undergo oocyte retrieval, surgery at a tertiary center will allow them to take advantage of onsite gynecologists and oncologists, allowing for a more seamless care coordination.

 

Although tertiary care centers serve an important role by offering complicated surgeries in a well-equipped environment, they also have drawbacks. While these facilities are ready to handle emergencies and complex cases, they are often located in big cities which makes them inaccessible to those living in rural areas. Their inherently large nature can also lead to longer wait times due to the higher volume of care that tertiary care centers provide (6). Moreover, it can create a bustling environment which some patients may find stressful and overwhelming.

 

For less complex surgeries, patients may consider seeking care in an outpatient setting. Procedures that can be undergone in a primary or secondary care facility afford patients the opportunity to remain closer to home while receiving care from a provider they are more likely to have a long withstanding relationship with. Common procedures such as tonsillectomies, hysteroscopies, and endoscopies can typically be performed at an outpatient center and often cost less than they would at a tertiary care center (7).

 

There are multiple important reasons why one should have surgery at a tertiary care center. For more complex surgical procedures that require the extensive care coordination of many specialists, a large hospital may be best equipped to provide the most technologically advanced care and thorough post-operative care. However, for more common surgeries, patients can look to the outpatient setting for low-cost care that is closer to home.

 

References

 

1. Lee, P., & Gawande, A. (2008). The number of surgical procedures in an American lifetime in 3 states. Journal of the American College of Surgeons, 207(3). https://doi.org/10.1016/j.jamcollsurg.2008.06.186
2. Bertoni, B. (2024, March 14). Primary, Secondary, Tertiary and Quaternary: Understanding Levels of Patient Care. Keiser University. https://www.keiseruniversity.edu/primary-secondary-tertiary-and-quaternary-understanding-levels-of-patient-care/
3. Shahian, D. M., Nordberg, P., Meyer, G. S., Blanchfield, B. B., Mort, E. A., Torchiana, D. F. & Normand, S. T. (2012). Contemporary Performance of U.S. Teaching and Nonteaching Hospitals. Academic Medicine, 87 (6), 701-708. https://doi.org/10.1097/ACM.0b013e318253676a
4. Zamzam, A. H., Abdul Wahab, A. K., Azizan, M. M., Satapathy, S. C., Lai, K. W., & Hasikin, K. (2021). A Systematic Review of Medical Equipment Reliability Assessment in Improving the Quality of Healthcare Services. Frontiers in public health, 9, 753951. https://doi.org/10.3389/fpubh.2021.753951
5. Kerr R. S. (2020). Surgery in the 2020s: Implications of advancing technology for patients and the workforce. Future healthcare journal, 7(1), 46–49. https://doi.org/10.7861/fhj.2020-0001
6. Study Reports Massachusetts Has Nation’s Second-longest ER Waiting Times. (2023, August 14). Health Care News. Retrieved June 24, 2024, from https://healthcarenews.com/study-reports-massachusetts-has-nations-second-longest-er-waiting-times/
7. Outpatient Surgery – Health Encyclopedia – University of Rochester Medical Center. (n.d.). https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P01404