Evaluation of costs and outcomes of physician-owned hospitals across common surgical procedures

Am J Surg. 2020 Jul;220(1):120-126. doi: 10.1016/j.amjsurg.2019.10.008. Epub 2019 Oct 8.

Abstract

Introduction: The Affordable Care Act introduced restrictions on the creation of new physician-owned hospitals (POH). We sought to define whether POH status was associated with differences in care.

Methods: Patients undergoing one of ten surgical procedures were identified using Medicare Standard Analytic Files. Patient and hospital-level characteristics and outcomes between POH and non-POH were compared.

Results: Among 1,255,442 patients identified, 14,560 (1.2%) were treated at POH. A majority of POHs were in urban areas (n = 30, 90.9%) and none were in low socioeconomic status areas. Patients at POH were slightly younger (POH:72, IQR:68-77 vs. non-POH:73, IQR:69-79) and healthier (CCI; POH:2; IQR: 1-3 vs. non-POH: 3; IQR: 1-4). Patients at non-POH had higher odds of postoperative complications (OR:1.67, 95%CI:1.55-1.80) and slightly higher medical expenditures (POH:$11,347, IQR:$11,139-$11,936 vs. non-POH:$13,389, IQR:$11,381-$19,592).

Conclusions: POH were more likely to be located in socioeconomic advantaged areas, treat healthier patients and have lower associated expenditures.

Keywords: Physician-owned hospitals.

MeSH terms

  • Health Expenditures / statistics & numerical data*
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Hospitals, Private / economics*
  • Humans
  • Ownership*
  • Physicians / economics*
  • Postoperative Complications / economics
  • Postoperative Complications / epidemiology*
  • Surgical Procedures, Operative / adverse effects
  • Surgical Procedures, Operative / economics*
  • Surgical Procedures, Operative / statistics & numerical data
  • United States