A Changing Service - Tertiary care

At the tertiary care level, the patient receives highly specialized, high-technology care and treatment. Complex programs and unusual procedures, among them open heart surgery, heart or kidney transplantation, and neurological surgery, are provided by physicians with extensive training and the advantages of sophisticated equipment for diagnosis and treatment. Often, care at this level is obtainable only if the patient enters a hospital with specialized facilities. Of the various tertiary care institutions, three key ones are hospitals specializing in a certain disease or a group of diseases, hospitals associated with medical schools, and large regional referral centers. Many such institutions would be expected to have diagnostic equipment for such procedures as cardiac catheterization, nuclear magnetic resonance testing, and CT scanning.

Importantly, the three levels of care overlap. The distinctions among them are not always clearly drawn or defined. For the patient, the most important factor may be the need for referrals at some levels and not at others.