Ranking varies on hospital costs On average, CCGH charges more for 8 services, less for 19

January 19, 1993|By Donna E. Boller | Donna E. Boller,Staff Writer

Carroll County General Hospital is generally a prett inexpensive place to be hospitalized, but its charges for labor and delivery, emergency room services and the coronary care unit are the highest among Maryland's 17 rural hospitals.

Hospital rates reported by the Maryland Health Services Cost Review Commission for 52 services, from admissions charges to magnetic resonance imaging (MRI), show that Carroll County General's charges are below the rural hospital average on 19 of the services it offers and higher than average on eight services.

Occupying a medical-surgical bed, the most common hospital experience, costs an average of $310 a day at Carroll County General, $30 less than the rural hospital average fee. Hospitals are allowed to charge slightly more for private rooms and less for semi-private, so long as the charge averages the established rate.

Officials at the local hospital strongly object to the rural classification. They argue that it is outdated and that comparing Carroll County General's rates with rural hospitals' charges is misleading.

However, the hospital has not asked the cost review commission to reclassify it as metropolitan, the other category for acute-care hospitals. Specialty hospitals, such as psychiatric hospitals, are classified separately.

Individual fees show some wide variations. Carroll County General's admissions charge, for example, is $68 lower than the highest charge, $108, levied by Washington County Hospital.

The local hospital's labor and delivery charge, $62 per procedure, is $40 higher than the lowest fee among rural hospitals, which is charged by Dorchester General.

Carroll County General's labor and delivery charges are higher because relatively few babies are born at the hospital, said Linda Harder, vice president for marketing.

The hospital has about 8,000 inpatients a year, only 600 of them obstetrics patients. The number of deliveries means a high nurse-to-patient ratio and individual attention for new mothers at Carroll County General, but it makes the hospital's costs higher than those at hospitals where more babies are delivered, Ms. Harder said.

Carroll County General has launched an advertising campaign to attract pregnant women and is renovating the unit, adding labor, delivery and recovery rooms. More babies delivered at the local hospital would bring unit costs down, Ms. Harder said.

Carroll County General charges an average of $104 for an emergency room visit, the highest among the rural hospitals. The fee is lowest, an average of $70, at Edward W. McCready Memorial Hospital in Crisfield.

The local hospital's coronary care unit charge, $893 a day, is higher than the two other rural hospitals in Maryland that have units for heart patients. Washington County Hospital in Hagerstown charges $762 a day; Peninsula General in Salisbury, $673.

Hospital officials were unable to explain directly why the emergency and other individual service charges are highest in the state among rural hospitals.

"Looking at specific charges is not that helpful in seeing how economical a hospital we are," said spokeswoman Gill Chamblin.

Ms. Harder said all hospitals charge higher-than-average fees for some services, lower-than-average for others. She said she doesn't see any pressure to change Carroll County General's rural classification because hospital officials look at statewide averages, not at their standing among rural hospitals.

John M. Colmers, the state cost review commission's executive director, said that whether a hospital is classed as rural or metropolitan has nothing to do with the rates it is allowed to charge.

Rural hospital fees tend to be lower overall than metropolitan fees, but not for all individual services, the cost review commission's statistics show. For example, Carroll County General's daily charge for patients under definitive observation -- the intermediate unit between coronary care and a regular medical-surgical bed -- is higher than fees for similar units at Suburban and Mercy Hospitals, both classified as metropolitan.

Carroll County General ranks 41st among the 51 Maryland hospitals in average cost per hospital visit. The cost review commission's statistics show that 69-bed Kernan Hospital has the highest cost, $6,399 per admission; 41-bed McCready Hospital has the lowest cost, $2,674. At $3,430, 148-bed Carroll County General is 2.69 percent less expensive than the average hospital.

Carroll County General's charges are lowest among rural hospitals for CAT (Computerized Axial Tomography) scans -- $89 per procedure -- contrasted with a high of $293 at Calvert Memorial Hospital.

The local hospital also is the least expensive among the rural hospitals list in its charges for electroencephalograms and diagnostic radiology.

"We aren't high [in charges] compared to Baltimore region hospitals," said Ms. Chamblin. "To put us in a category with rural hospitals is meaningless."

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