The joint-replacement hospital Coxa Oy incorporates top know-how in joint-replacement surgery into part of a public-sector service. The operating model is unique not only in Finland but also internationally. It can also be copied for other specialized areas of medicine.

"We thought about Coxa's operating concept carefully and open-mindedly before implementing it. We felt that the limited-company form was important for it to be possible to arrange the operations of a hospital serving the public sector in a way that was new and previously untried," says CEO Matti Lehto.

"The limited-company form gives the hospital clear autonomy. We can follow our customer-oriented strategy and invest in the staff. Private money brings new freshness and a commercial way of thinking."

Coxa, which was established in 2001, acts as a subcontractor in carrying out joint-replacement operations for its own hospital district in accordance with a service agreement that is made annually and in providing the most demanding surgery services nationwide. Surgery is also carried out on patients who pay for the treatment themselves.

"Our experiences show that the Coxa model is worth copying. Interest has been kindled both in Finland and worldwide."
Lehto says that other suitable areas could be those that are clearly defined such as cataract surgery, the treatment of heart diseases, rheumatic diseases and kidney diseases.

Good results

Coxa's smooth running is based on an efficient treatment process and high utilization rate. The reward for concentration is quality. At Coxa one surgeon every year performs as many artificial joint operations as all the surgeons at many hospitals. "Routine and repetition refine the surgeons' professional skills, making them top-class."

The process-like nature of the operations reduces hospital treatment time considerably and, with it, costs and complications. The proportion of complications at Coxa, such as infections, is abnormally low compared with the international level.

The number of re-operations has fallen considerably, which means substantial cost-savings. "We have also achieved excellent results in customer-satisfaction surveys," reports a delighted Lehto.

Satisfied staff

The independently operating hospital gives the staff new scope for concentrating on the constant development of their own field and work.

"We've succeeded in creating a positive and forward-pointing spirit in spite of a noticeably brisk work pace. Contributing to this have been the flexible working practice, teamwork, real freedom to have an influence and performance-related pay."

Coxa is number one in Finland for the number of operations. During 2006 2,600 artificial joint operations will be carried out there. The number has increased rapidly: in 2003 it was just under 1,500. Future growth is put at five per cent per year.

>> www.coxa.fi

"The need for artificial joint operations is increasing constantly with population ageing, bone-degeneration and problems of overweight. The development of implant technology is also bringing new patient groups within the sphere of the treatment," says Matti Lehto.