September 23, 2008
Outpatient Care Center Construction Raises Cost Concerns
By Kevin Lamb Staff Writer
SPRINGBORO -- Compared to the 232,000-squarefoot structure its Cincinnati counterpart opened on I-75 last month, the Dayton Children's Outpatient Care Center -- Springboro won't seem much bigger than a waiting room when it opens 21 miles up the road in November.
It has less than one-tenth the space of Cincinnati Children's Hospital Medical Center's new Liberty Twp. facility. Even counting the new physicians building at Atrium Medical Center in Franklin, Dayton Children's will add less than one-fifth of Cincinnati's new space.
But then it's not really trying to answer Cincinnati Children's.
"We build for what we think our needs are," said Matt Graybill, Children's Medical Center's vice president for business development and planning. "The last thing we want to do is build a huge and expensive building, raise everybody's health care costs and have it not be ."
As hospitals seem to be building at the rate of 1960s school construction, the impact on health care costs is a big worry for businesses already staggering under the weight of insurance premiums. A region's per-capita health spending tends to rise with the supply of doctors and hospitals -- not with the demands of people's health status, considerable research shows. But health quality doesn't rise with them.
Children's hospitals are different, though. They have far fewer patients receiving expensive end-of-life treatment, no customers among the large and lucrative Baby Boom demographic and less competition from other hospitals. In Southwest Ohio, the pediatric hospitals' relationship is "collaborative as well as competitive," said Dee Ellington, Graybill's Cincinnati counterpart, and even includes the sharing of patients.
"This Springboro facility is really an example of Dayton Children's bringing their services out to where the community is," said Rich Gunza, the Cincinnati resident who directs the Dayton office of Anthem Blue Cross and Blue Shield. He drives through the weedlike growth of Butler and Warren counties every day.
Since the Springboro center meets a clear patient demand, Gunza said, "I'm not worried from a cost standpoint that having more services available will bring about higher
utilization than the community needs.
"But what does concern me
is that when you move from
an old, paid-for facility to a
new one with all the technology, that cost all gets built
back into the hospitals' pricing structure. I think any time
there's new construction, a
community needs to ask the
question, 'OK, it's great to
have this new facility, but is it
really worth the extra cost?'
That question doesn't get
asked often enough."
Upgrading technology is one reason for the Springboro satellite, Graybill said. The Kettering Urgent Care center will become the Kettering Testing Center, with just imaging and lab testing when Dayton Children's moves its urgent care and rehab operations to Springboro.
Equipment for breathing problems will be built into the Springboro walls instead of on portable carts. Doctors will be able to stitch up urgent-care wounds without "hauling a big light into the room," Graybill said. Physical therapists will have the small gym that "you really need for pediatric rehab."
Dayton Children's can spend considerably less to modernize, however, than Cincinnati. "We have the second-largest pediatric research enterprise in the country," Ellington said, trailing only Children's Hospital Boston. Research brings myriad specialties and highend treatments, so Cincinnati Children's Liberty Campus has 29 specialty clinics and surgery for 11 specialties.
All those specialists give Cincinnati a competitive advantage, but Ellington said, "Dayton Children's supplies the services needed by the vast majority of people." A choice between the two hospitals, he and Graybill agreed, also can come down to the doctor's preference, which facility has the shortest wait for an appointment and of course, geography. Middletown and Lebanon form a nominal dividing line between the hospitals.
"Dayton Children's has always had a real good outreach program in Middletown," Gunza said. "You don't hear a lot about it because they just go about filling community needs without a lot of fanfare.
"But when they build the Austin Road interchange, these guys will look like geniuses."
Contact this reporter at (937) 225-2129 or klamb@DaytonDailyNews .com.
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