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The lack of any correlation between surgical proportion and case mix essentially means that a hospital with more surgeries does not translate into a more complex hospital.
Evidence on more complex hospital substitution programs is encouraging with systematic reviews on home-based care [ 9], early discharge programs [ 10] and best place of care [ 11] all suggesting that care can be delivered outside hospital and achieve comparable outcomes.
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The reality at this stretch of the border is more complex, with hospitals reporting some immigrants arriving to give birth in the United States but many of them frequent border crossers with valid visas who have crossed the border legally to take advantage of better medical care.
"There are no buildings that are more complex than a hospital".
The situation was even more complex when these hospitals had a different status (public, private, or not-for-profit).
Krumholz et al. showed that a simple 7-variable risk model performed as well as more complex models in comparing hospital outcomes for AMI.
Focusing on the distinct SHI categories, the utilization of routine services increases at higher care levels, but more complex services (medical specialist, hospital, rehabilitation) are utilized less frequently.
For CPT complexity the only difference was that A hospitals had more complex surgical procedures than C and D hospitals.
The aim of this study was to compare the discrimination capacity and fit of predictive models of CD created using different sources and to assess whether more complex models improve inter-hospital comparisons.
Conflict exists due to the perception of "cherry picking" by specialty hospitals, leaving the more complex and poorer reimbursed patients at community hospitals.
He told the BBC: "Much older people with much more complex needs are coming into hospital.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com