Comment by ssl-3

AFAIK, hospital-grade outlets differ mostly by having an isolated ground. The ground terminals and the mounting points do not share a conductive path, which is sometimes useful in some nuanced ways in hospital environments.

Spec grade tends to go the other direction with that: A lot of these are self-grounding. What that means is that there's a deliberate conductive path between the ground terminals and the mounting points. When properly fastened to a grounded metal box, it can become unnecessary to use the ground screw on the back of the outlet.

Both grip things that are plugged in about the same, in my experience. It seems likely that they share many of the same components inside.

And yeah: Cheap outlets (including "contractor grade") are junk. They take longer to install, they loosen up over time, and they do everything worse. If an house has 50 cheap outlets instead of 50 decent outlets, then someone saved $75 on materials -- but probably paid more than that in additional labor hours. They're reprehensibly stupid.