HOSPITAL MERGERS: QUALITY OF CARE NOT IMPACTED
"Patient care appears to be unchanged after hospitals mergeThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
or are bought by other institutions," according to the
preliminary results of a new study by Washington University
health care economists. The St. Louis Business Journal reports
that the research shows that "mergers and acquisitions have
little impact on two key measures of quality -- length of a
patient's stay and inpatient mortality, or the number of patients
who died before discharge from the hospital." The study "focused
on transactions involving 370 hospitals in California between
1994 and 1996," including 19 independent hospitals which had
merged; "56 acquisitions of independent hospitals by hospital
systems"; "70 acquisitions of one hospital system by another";
and "20 acquisitions by Columbia/HCA Corp." The economists
studied approximately 130,000 heart disease patients admitted to
acute care facilities between January 1991 and June 1996.
The researchers found that the average length of a hospital
stay "fell by a full day, from 5.74 days in 1991, to 4.74 days in
1995." The hospitals that showed bigger declines in average
length of stay were those "not involved in mergers or
acquisitions" and the independent hospitals that merged.
Independent hospitals showed the greatest declines in inpatient
mortality (down .018%), followed by hospitals not involved in
mergers (down .012%), hospitals acquired by another system (down
.007%) and hospital systems acquired by another system (down
.005%). However, the hospitals acquired by Columbia displayed an
increased inpatient mortality, "from 48 patients per 1,000 in
1991, to 53 patients per 1,000 in 1995." One of the researchers,
Vivian Ho, said, "Columbia may have been taking in sicker
patients to begin with. We can't determine that." The Business
Journal notes that the study's time period "coincide[s] with the
growth of managed health care insurance companies, which
generally try to reduce costs by encouraging less expensive
outpatient treatment over lengthy inpatient stays."
Ho noted that future investigations will focus on "whether
merging hospitals actively try to screen for healthier patients
and whether there is a difference between hospitals in rural and
urban settings." Ho also wishes "to expand the analysis to look
at readmissions" (Manning, 1/26).