Private equity ownership of hospitals made care riskier for patients, a new study finds

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CNN
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Health care became more hazardous for patients at hospitals purchased by private equity firms, a new study shows.

The sweeping study, which was published Tuesday in the journal JAMA, looked at the rates of 10 serious adverse events associated with medical care at 51 hospitals before and after they were purchased by private equity firms — a financing model designed to make money for investors. The researchers then compared those results with the rates of the same complications at 259 hospitals that were not owned by private equity firms.

Private equity firms have been acquiring large chunks of the US health care delivery system in recent years. In addition to hospitals, those acquisitions include nursing homes, behavioral health systems, and private physician practices. Academic research has shown that private equity ownership is associated with higher death rates for patients in nursing homes and increased costs to taxpayers. Earlier this month, the Senate Budget Committee announced its bipartisan investigation of the impact of private equity purchases on health care facilities.

Many of these complications are designated “never events” because they’re preventable medical errors that should never occur during routine care, such as leaving a foreign object in the body after surgery, failing to correctly match a patient’s blood type, falls, infections at certain kinds of surgical sites or where doctors insert catheters or central lines, blood clots after joint replacement surgeries and pressure sores.

Researchers said they did the study because, while there has been some evidence to show the economic outcomes after private equity firms purchase hospitals, such as increased billing rates, there’s been little understanding of how this business model may impact patient care.

The study found that rates of hospital-acquired complications for patients increased by 25% at hospitals after they were purchased by private equity firms.

Study author Dr. Zirui Song said the increase was driven by a 27% increase in falls, which tend to happen on the general floors of the hospital; a 38% increase in central line infections, which are associated with ICU care; and a doubling of the rates of surgical site infections.

The increase in central line infections happened despite private equity-owned hospitals inserting about 16% fewer central lines — ports into large veins that are surgically implanted in patients who need regular intravenous medication, food or fluids.

“In all three so-called layers of the hospital, from the general floors to the ICUs to the operating rooms, we saw a quite striking and concerning average change,” said Song, who is an associate professor at Harvard Medical School, in an interview with JAMA editors.

Experts who have been tracking the impact of private equity ownership in health care called the findings “stunning.”

“I have to say that the number is even higher than than what I expected,” said Eileen O’Grady, who is the health care research and campaigns director for the Private Equity Stakeholder Project, which aims to hold private equity groups accountable.

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