Patient Experiences Modestly Worse After Hospital Acquisition

Modestly worse patient experiences are seen following hospital acquisition by another hospital, according to a study published in the Jan. 2 issue of the New England Journal of Medicine.

Nancy D. Beaulieu, Ph.D., from Harvard Medical School in Boston, and colleagues used data from 2007 through 2016 on performance of four measures of quality of care as well as data on hospital mergers and acquisitions from 2009 through 2013 to compare changes in the performance of acquired hospitals with concurrent changes for control hospitals without change in ownership. Data were included for 246 acquired hospitals and 1,986 control hospitals.

The researchers observed a modest differential reduction in performance on the patient-experience measure with being acquired (adjusted differential change, −0.17 standard deviation [SD]; 95 percent confidence interval [CI], −0.26 to −0.07; P = 0.002); no significant differential changes were seen in 30-day readmission rates (−0.10 percentage points; 95 percent CI, −0.53 to 0.34; P = 0.72) or in 30-day mortality (−0.03 percentage points; 95 percent CI, −0.20 to 0.14; P = 0.72). A significant differential improvement in performance was seen on the clinical-process measure in acquired hospitals (0.22 SD; 95 percent CI, 0.05 to 0.38; P = 0.03); the differential improvement occurred before acquisition and therefore could not be attributed conclusively to a change in ownership.

"These findings challenge arguments that hospital consolidation, which is known to increase prices, also improves quality," the authors write.

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