ISTCs treat healthier patients
Patients undergoing surgery in independent sector treatment centres (ISTCs) have better outcomes than comparable patients treated in NHS centres, a study has found.
The research also showed that ISTC patients tend to be younger, healthier, less sick, and be from more affluent areas than NHS patients - fuelling fears of "cherrypicking" by private units and the creation of a "two-tier" system.
Commenting on the study, Professor Norman Williams, president of the Royal College of Surgeons, said: "We need to guard against any drift that could destabilise hospitals. Sicker patients have needs that only a comprehensive hospital can provide."
ISTCs were introduced in England in 2002, with the stated aims of reducing waiting times and increasing patient choice in the field of non-emergency services. However, clinicians have raised concerns about the quality of care provided by ISTCs and their potential destabilising impact on NHS service provision and surgical training.
In this study, Professor Jan van der Meulen (London School of Hygiene and Tropical Medicine) and colleagues compared patient characteristics and clinical outcomes for four common surgical procedures. Information on approximately 25,000 patients treated at 25 ISTCs and 72 NHS providers was analysed.
Results, published in BMJ, showed that ISTC patients had a more "favourable casemix profile" than NHS patients, "though the differences were small". With adjustment, clinical outcomes were better for ISTC patients for most procedures, in terms of symptoms and disability and health-related quality of life.
Again, however, the researchers say the differences are "minor" and "unlikely to be clinically significant".
GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Joanna Lyford