What doesn’t work: Tertiary care hospitals

(photo credit: Liz Highleyman)

Okay, it's a bit of a stretch to say that tertiary care hospitals don't work. They do just fine at providing ultra-high level care to a few people. The problem is that developing countries don't generally have a few people suffering from illnesses that require extremely sophisticated care.

Developing countries have a lot of people with illnesses that need basic health care and medications. People die from things like diarrhea and measles. People are lucky if they live long enough to require a tertiary care hospital; they are being killed by the kinds of things that could be cured by a neighborhood clinic.

This leads us to the obvious conclusion that we need more neighborhood clinics. We need accessible health care within easy walking distance. Mothers need to take their children in for vaccination without putting their other children at risk, a place to go in the middle of the night when the baby is too sick to drink or breastfeed.

Tertiary care hospitals have a role in the health care system, but it's not a big role. They shouldn't see the majority of patients, and they shouldn't get the lion's share of the funding. Tertiary care belongs at the top of a pyramid. It's not the foundation for good health care; it's the health care of last resort. The WHO has statistics about how many tertiary care hospitals are actually necessary for given population levels. Those are useful numbers.