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The rate of hospital-acquired complications among hospitalized patients rose 25% after they were purchased by private equity firms, according to a new study.
CNN –
Health care has become more dangerous for patients at hospitals bought by private equity firms, a new study shows.
The comprehensive study, published Tuesday in the journal JAMA, examined the rates of 10 serious adverse events related to medical care at 51 hospitals before and after they were purchased by private equity firms – a financing model aimed at making money for investors. The researchers then compared these results with the Rates of the same complications in 259 hospitals not owned by private equity firms.
Private equity firms have taken over large parts of the US healthcare system in recent years. In addition to hospitals, these acquisitions include nursing homes, behavioral health systems and private medical practices. Scientific research has shown that private equity ownership is associated with higher mortality rates for nursing home patients and higher costs to taxpayers. Earlier this month, the Senate Budget Committee announced its bipartisan investigation into the impact of private equity purchases on healthcare organizations.
In total, researchers analyzed the outcomes of nearly 5 million hospitalizations available through Medicare claims data. The researchers had at least three years of data for each hospital included in the analysis.
Many of these complications are referred to as “never events” because they are preventable medical errors that should never occur in routine care, such as: B. Leaving a foreign body in the body after surgery, misidentifying a patient's blood type, falls or infections, certain types of surgical sites or places where doctors insert catheters or central lines, blood clots after joint replacement surgery, and pressure ulcers.
The researchers said they conducted the study because while there is some evidence of the economic consequences of hospitals being purchased by private equity firms, such as: B. higher billing rates, but there is little understanding of how this business model could impact patient care.
The study found that the rate of hospital-acquired complications among patients in hospitals increased by 25% after they were purchased by private equity firms.
Study author Dr. Zirui Song said the increase was due to a 27 percent increase in falls, which typically occur on the general floors of the hospital; a 38 percent increase in central line infections associated with critical care; and a doubling of the rate of postoperative wound infections.
The rise in midline infections came even as hospitals owned by private equity firms inserted about 16% fewer central lines — ports in large veins that are surgically implanted in patients who require regular intravenous medications, foods or fluids.
“Across all three so-called tiers of the hospital, from the general floors to the intensive care units to the operating rooms, we saw a pretty striking and concerning average change,” said Song, an associate professor at Harvard Medical School, in an interview with JAMA Editors.
Experts who have studied the impact of private equity ownership in healthcare called the results “astonishing.”
“I have to say the number is even higher than I expected,” said Eileen O’Grady, director of health research and campaigns at the Private Equity Stakeholder Project, which aims to hold private equity groups to account.
O'Grady said the research makes sense based on what she hears from people who work in hospitals that have been acquired by private equity firms, but she believes this is the first time a study has been done could partially quantify patient outcomes because there is little transparency in private equity deals.
How exactly would owning a private equity firm impact patient care? Song says they can't answer this question based on Medicare claims data alone, but previous research has shown that these types of takeovers are often associated with downsizing and replacing higher-paid workers, such as doctors and nurses, with lower-paid employees. paid employees.
“So downsizing is a possible mechanism that has been documented at least in the private equity context,” Song said.
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There was also a slight shift in patient demographics at hospitals owned by private equity firms over the study years. In general, there was a trend at these hospitals to treat fewer patients eligible for Medicare and Medicaid benefits, a reflection of lower-income patients. Private equity hospitals also began accepting slightly younger patients and were more likely to transfer patients to other acute care hospitals.
Ultimately, Song said, there is clinical decision-making, and acquisition by private equity firms can impact that.
“On average, we see frontline physicians making decisions that result in disparities in their clinical outcomes, at least for the Medicare recipient population,” he said.
Song said there needs to be more research on how financial considerations associated with private equity ownership may impact clinical decision-making. He hoped similar studies would be conducted for other types of healthcare facilities, such as doctor's offices, telemedicine and even behavioral health practices.