Patients admitted to hospitals owned by privately held companies suffer more surgical and bloodstream infections and also fall more frequently, a new study by academics at Harvard University and the University of Chicago revealed.
The research, published Tuesday in the Journal of the American Medical Association, comes after previous studies showed that patients in privately held clinics pay higher costssuffer the consequences of staff reductions and, in the case of nursing homes, have higher mortality rates.
The new study was conducted by Drs Sneha Kannan and Zirui Song, both of Harvard, and Joseph Dov Bruch, of the University of Chicago. The report was based on the health records of patients in privately held hospitals, an area in which research has been scarce.
These are hospitals owned by investors, as opposed to those that are public or funded by universities or charities.
According to the new findings, Private equity companies have bought more than 200 hospitals. In addition, it is estimated that 40% of hospital emergency services throughout the United States are managed by companies that provide staff and are also operated with private capital.
Research that had already been published on the topic of privately held hospitals “focused heavily on financial profits, staffing, as well as some measures of process quality,” Song said in an interview with NBC. News. “Our goal was to examine changes in more significant factors such as the quality of medical care in these health centers after they were sold,” she explained.
Private equity firms are sophisticated investors who buy companies, typically putting them into deep debt to pay for the acquisitions, hoping to sell them in a few years for a profit. In the last decade, these companies have invested 1 billion dollars in healthcare entities, seeing great financial benefits.
As debt adds a financial burden to acquired companies, their owners often cut costs by laying off workers. They also try to generate more revenue by increasing prices for customers. Some hospitals owned by private equity companies sell the land under their buildings: these operations enrich their owners, who receive the money generated by the sales, but burden the centers with higher rents.
Preventable infections and accidents
Song and his colleagues compared Medicare bills from patients at 51 hospitals owned by private equity companies with data from 259 health centers, of similar size and location, that were not owned by those companies.
To compare healthcare before and after the acquisition, the academics studied a period starting three years before the hospitals were acquired and three years after.
The acquisitions of the 51 hospitals took place between 2010 and 2017. The study did not identify the health centers whose results it recorded, nor the private equity companies that owned it.
According to the study, after the hospitals were acquired by private equity companies, patients at these centers experienced an average 25.4% increase in acquired problems such as infections and falls, compared to those treated at other hospitals in the same period of time. time.
Patients at privately held centers experienced a 27% increase in falls and a doubling of surgical infections, despite an 8% decrease in surgical case volume.
Patients at privately held hospitals participating in the study also experienced an average 38% increase in central line infections, which is when germs enter the bloodstream through a tube placed in a vein of the neck, chest or groin. This increase occurred, according to the researchers, despite the fact that these centers had operated 16% fewer central lines on patients.
Hospital-acquired conditions, such as infections or falls, “are considered preventable according to guidelines from the Centers for Medicare and Medicaid Services.” Medicare reimbursements to hospitals decrease when facilities experience high numbers of hospital-acquired infections.
Congress gets involved
The study is published amid increasing scrutiny over the ownership of healthcare entities by private equity firms. Earlier this month, two senators announced a bipartisan investigation into the impact of these companies on the country’s healthcare system.
This investigation, launched by Sen. Chuck Grassley, R-Iowa, and Sheldon Whitehouse, D-Rhode Island, focuses on Lifepoint Healtha hospital chain owned by Apollo Global Management, and Prospect Medical Holdingsa health center operator owned until recently by Leonard Green & Partners, a Los Angeles private equity firm.
The senators requested information from the companies to evaluate the benefits they have generated through their complex financial arrangements, and whether the operations have harmed patients and doctors.
In September, the Federal Trade Commission (FTC) sued US Anesthesia Partners Inc, one of the nation’s leading anesthesia staffing firms, and the private equity company that backed it, Welsh, Carson, Anderson & Stowe.
The FTC accused them of planning for a decade to acquire anesthesia practices in Texas, monopolize the market, raise prices for patients and generate profits. Both deny the accusations and oppose the lawsuit.
Previous studies have detected adverse effects when private equity owns a healthcare company. A 2021 study by the American Antitrust Institute and the Petris Center at the University of California, Berkeley School of Public Health concluded that “the Private equity business model is fundamentally incompatible with sound healthcare at the service of patients.”
The results of the research published Tuesday in JAMA “raise concern about the implications of private capital on health care delivery,” the authors concluded.
Song told NBC News that he and his colleagues continue to study the impact of private equity on healthcare. The research, he noted, reflects “the actual clinical quality of care on the ground.”
He added: “This type of result could change the narrative around the impact of private equity on the quality of care and patient outcomes.”
