Tertiary Care

Tertiary care is highly specialized care, requiring the skills of individuals with advanced educational and practical experience in the management of complex illness. It also typically is provided in facilities that have high-technology equipment capabilities and are accustomed to providing subspecialty services not available in general acute care hospitals.

Such care should be differentiated from primary care and secondary care. Although dependent somewhat on the definition used, primary care usually refers to care provided by family practice, internal medicine, obstetric, and pediatric physicians. Secondary care typically refers to short-term care provided by specialists or subspecialists in their offices or in the general acute care hospital, often helping the primary care physician solve a diagnostic dilemma.

Physicians involved in providing tertiary care typically are subspecialists with special training either in diagnostic procedures such as cardiac catheterization or surgical procedures such as neurosurgery. Because tertiary care often requires high-technology equipment, other individuals involved may be highly skilled technicians or nurses.

Hospitals providing tertiary care often are large, regional referral centers or university-and medical school-affiliated facilities. They may, however, be community hospitals that have developed certain specialized service lines such as cardiovascular surgery or cancer care.

Both the physicians and the hospital facilities involved in providing tertiary care are also often involved in[Page 560] providing primary and secondary levels of care. It is therefore the level of care being provided rather than the provider that determines the appropriate application of the term tertiary.