Hospital mergers and acquisitions may precipitate a modest decline in patient care quality; however, no differential changes in readmission or mortality rates were observed in acquired institutions compared with control hospitals, a recent study published in the New England Journal of Medicine reports.
Investigators abstracted data from Irving Levin Associates on hospital acquisitions for the years 2007-2016. Acquired hospitals for which the transaction occurred in 2009-2013 were eligible for inclusion. A control group was constructed of hospitals with no change in ownership during the study period. For each hospital, Medicare Hospital Compare data from 2007-2016 were assessed for clinical-process and patient-experience measures.
The clinical-process measures comprised 7 measures related to cardiac, pneumonia, and perioperative care; patient-experience measures included 5 items from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Additional primary outcome measures included all-cause rate of readmission and all-cause rate of death within 30 days of discharge. Admission-level data derived from Medicare claims were used to compute hospital characteristics, including number of beds, teaching status, ownership type, and location in a rural area. Difference-in-differences analyses were conducted, comparing changes in the performance of acquired hospitals from the pretransaction to the post-transaction period with changes in the performance of same-state control hospitals during the same time period. Differential changes between hospitals were expressed as standard deviations (SDs) of the differences between means.
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