Smaller-scale inpatient facilities, termed “micro-hospitals”, have emerged as an alternative to traditional health care facilities and seem to be growing in popularity nationwide. Already in 19 states, according to a recent US News & World Report, micro-hospitals serve as a middle ground between full-scale hospitals and freestanding urgent care and ambulatory centers. Tailored to suit the local demographics, these small hospitals are able to provide medical services in underserved areas and cater to the needs of their communities. Because the services provided depend on such needs, each micro-hospital varies from the next.
Most micro-hospitals are low-trauma facilities with varying advanced surgical capabilities that provide 24/7 care. According to the Advisory Board, there is an average of eight to ten beds for observation and short-stay use per micro-hospital, and the buildings usually range from 15,000 to 50,000 square feet. The core services of a micro-hospital include an emergency department, pharmacy, laboratory, and imaging, while ancillary services can consist of primary care, low-acuity outpatient services, women’s services, and dietary services (2). There is no standard way to staff a micro-hospital, however, their provision of some of the acute and emergency services frequently performed in bigger hospitals necessitates essential anesthesia service providers and board-certified, emergency room-trained physicians. Spinal surgery, endoscopic procedures, plastic surgery, and cardiac catheterization are a few examples of the types of procedures performed in micro-hospitals (1).
Micro-hospitals are often established in areas with specific medical needs that are unable to support a full-service facility. Many of these small hospitals are used by health systems as entry points into markets where demand also prevents the support of larger facilities (2). Micro-hospitals can either be built by existing major hospitals with preexisting internal facility development capabilities or by groups of doctors partnering with external organizations and micro-hospital developers. The location and size of micro-hospitals enable them to offer more accessible, convenient and patient-centered care compared to major hospitals. The cost of building a micro-hospital, estimated by the Advisory Board to range from seven to thirty million dollars, is also considerably less expensive than that of their larger counterparts. Because of their small scale, however, not all medical situations can be addressed, and patients must be sent to larger facilities. In order to ensure a smooth transfer process when needed, a micro-hospital is recommended to be built within 18 to 20 miles of a full-service hospital, according to the Advisory Board. In today’s health care climate, micro-hospitals present a possible health care delivery model to reduce costs and improve delivery of care, although “critics are wary about the facilities and safety they provide to the patients and how much experience doctors get while practicing in such a small facility” (1).