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Hospitals under private equity (PE) ownership reported higher rates of patient complications when compared to other facilities, according to a recent JAMA study—raising questions about how the business model might affect staffing and subsequent quality of care.
The surveyed Medicare beneficiaries saw a 25.4% increase in “hospital-acquired conditions,” which the Centers for Medicare and Medicaid Services defines as falls, infections, and other adverse events, when they received treatment at a PE-acquired hospital compared to those run under other forms of ownership.
On the whole, the study found that Medicare enrollees at hospitals under PE control were not only younger and less likely to additionally qualify for Medicaid but also more likely to experience complications.
Bloodstream infections at PE-run hospitals were 37.7% higher than in other hospitals, according to the study. Falls were 27.3% higher, and surgical site infections occurred at a rate of 21.6 per 10,000 hospitalizations—double that of non-PE hospitals, per the study.
The researchers, who are associated with institutions in Boston and Chicago, analyzed 662,095 hospitalizations at 51 PE-run hospitals and more than 4 million hospitalizations at 259 hospitals under other forms of ownership. They suspect that staff shortages play a role in these trends.
“A reduction in staffing can increase the rates of these complications,” Sneha Kannan, a physician and clinical research fellow at Harvard Medical School, who coauthored the study, told Healthcare Brew.
Kannan pointed to another study, published in the BMJ last year, that found “in some instances, PE ownership was associated with reduced nurse staffing levels or a shift toward lower nursing skill mix.”
“Private equity, as a form of ownership, is thought to be short-term,” she said. “They typically hold on to their acquisition targets or assets for a short, finite period—and then ultimately divest their interest and sell to another owner.”
The American Investment Council, a lobbying, advocacy, and research group that represents private equity, disputed the study’s findings on its website.
“Broader research continues to demonstrate private equity’s positive impact on patient outcomes and support for high-quality care delivery across the country,” according to the American Investment Council.