title: Orthopaedic surgeons do not increase surgical volume after investing in a specialty hospital.
abstract: BACKGROUND
  The number of surgical specialty hospitals with physician investors in the United States has increased in the last ten years. Opponents to these hospitals have argued that surgeon investors will perform more surgery in order to maintain the hospital's profitability. The purpose of the present study was to determine whether the surgical volume or the surgical rate increased for a group of ten orthopaedic surgeons after the opening of an orthopaedic surgery specialty hospital in which they held a financial interest.
  
  
  METHODS
  We analyzed the practice data for ten orthopaedic surgeons during an interval spanning seven years before and eight years after the opening of an orthopaedic surgery specialty hospital in which they held a financial interest. The average rates of change in the number of surgical procedures per year for each period were computed and compared with use of regression analysis. The percentages of patients who underwent surgery before and after the opening of the specialty hospital were also compared.
  
  
  RESULTS
  The ten orthopaedic surgeons did not increase their surgical volume or surgical rate after the specialty hospital opened. The ten surgeons performed an average of 4399 surgical procedures per year before the hospital opened and 4542 surgical procedures per year after the hospital opened. The rate of change in the number of surgical procedures per year (19.1 compared with 8.9 procedures per year) did not increase after the specialty hospital opened. The annual patient volume (16,019 compared with 15,982 patients) and the percentage of patients who underwent surgery (27.5% compared with 28.4%) did not significantly change after the specialty hospital opened.
  
  
  CONCLUSIONS
  The opening of an orthopaedic surgery specialty hospital did not increase the surgical volume or the surgical rate for ten orthopaedic surgeons who held a financial interest in the facility.
authors.affiliation: Fondren Orthopedic Group LLP, Texas Orthopedic Hospital, 7401 South Main Street, Houston, TX 77030-4509, USA. info@jwkoi.com
authors.forename: G William
authors.initials: GW
authors.lastname: Woods
authors.forename: Daniel P
authors.initials: DP
authors.lastname: O'Connor
authors.forename: Peggy
authors.initials: P
authors.lastname: Pierce
mesh_terms: D006782:Hospitals, Special / Q000191:economics*; D006801:Humans; D007449:Investments; D019637:Orthopedic Procedures / Q000191:economics / Q000706:statistics & numerical data*; D009985:Orthopedics / Q000191:economics* / Q000706:statistics & numerical data; D018584:Physician Self-Referral / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013781:Texas