ER Deaths Surged in US Hospitals Taken Over by Private Equity, Study Finds
Patient Deaths Rise After Private Equity Acquisition of U.S. Hospitals, Study Finds
A recent nationwide study has found that patient deaths increase in U.S. hospitals after being acquired by private equity firms. Conducted by researchers from Harvard Medical School, the University of Pittsburgh, and the University of Chicago, the study reveals a significant rise in mortality rates within the emergency departments (ED) of these hospitals compared to similar hospitals not acquired by private equity.
Among Medicare patients—who are often older and more vulnerable—the study highlights potentially dangerous and even deadly consequences linked to private equity ownership. Dr. Zirui Song, professor of healthcare policy at Harvard and general internist at Massachusetts General Hospital, explained in a statement, “Among Medicare patients, these financial strategies may lead to potentially dangerous, even deadly consequences.”
Key Findings
The study found that after acquisition by private equity firms, mortality among Medicare beneficiaries in emergency departments increased by 13 percent on average. This equates to seven additional deaths per 10,000 ED visits, rising from a baseline of 52 deaths per 10,000 visits. Compared to non-private equity control hospitals, this represents a noteworthy increase in risk.
Additionally, the research revealed an 18 percent average reduction in ED salary expenditures post-acquisition. Such cuts likely reduced the hospitals’ capacity and bandwidth to deliver care, which may explain the increase in mortality. In intensive care units (ICUs), salaries were cut by 16 percent. Although ICU mortality did not show a significant overall change, sicker ICU patients—such as those intubated, on dialysis, or needing blood transfusions—were more frequently transferred to other hospitals. Remaining ICU patients tended to have shorter stays, consistent with reduced staffing levels.
Impact on Transfers and Staffing
Dr. Song noted that the increase in mortality coincided with more ED patients being transferred to other facilities, who are typically sicker. Staffing and salary cuts appear to be common strategies used by private equity firms to generate financial returns for investors, potentially compromising patient care quality.
Study Methodology
The researchers analyzed more than 1 million emergency department visits and 121,000 ICU hospitalizations across 49 private equity–owned hospitals between 2009 and 2019. These were compared with over 6 million ED visits and 760,000 ICU hospitalizations across 293 control hospitals. The analysis relied on traditional Medicare claims data and hospital cost reports.
Related Research
A 2023 study found a 25 percent increase in preventable adverse events—including infections—in hospital inpatient wards following private equity acquisitions, which is also believed to be related to staffing reductions.
Balancing Potential Benefits and Risks
While private equity investment can, in theory, bring much-needed capital and management expertise to struggling healthcare facilities, Dr. Song cautions that this is not always the case. “Private equity firms are more likely to acquire financially healthier hospitals that can take on new debt while still generating revenue,” he said. This contradicts the common perception that private equity acquisitions primarily target struggling hospitals for turnaround efforts.
Study Limitations
The authors acknowledge several limitations, including the variability in private equity acquisition strategies and the possibility that their sample of acquired hospitals may not represent all acquisitions nationwide.
Conclusion
This study contributes to growing evidence that private equity ownership in hospitals can adversely affect patient outcomes, particularly in emergency care settings. Further research is needed to understand the mechanisms behind these changes and to develop policies that prioritize patient safety amid evolving healthcare ownership models.
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https://www.newsweek.com/er-patient-deaths-us-hospitals-private-equity-2133777
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