You're more likely to catch an infection or fall at these hospitals
Patients cared for in hospitals owned by investors, as opposed to public hospitals or those owned by universities or charitable organizations, are more likely to catch infections and suffer falls, a new study finds.
Surgical site infections doubled, even though fewer surgeries were performed at 51 hospitals bought by private equity investment groups compared with 259 hospitals that were not. Bloodstream infections associated with central line catheters jumped by 38% in the same three years after a private equity purchase, despite a decline in the placement of these tubes. Falls rose by 27% in that time span.
Overall, patients receiving Medicare at private-equity-owned hospitals experienced 25% more dangerous events during their hospital stays the study found.
Private equity may be good for investors, but it's not good for patients, said Dr. Zirui Song, lead author of the paper, published Tuesday in the Journal of the American Medical Association.
Another co-author published a paper this summer showing the cost of care also increases after hospitals are purchased by private equity groups.
Private equity firms raise money from investors, such as endowments and state pension funds. They borrow the rest, using assets such as a hospital's land and building as collateral for the loan. They aim to increase the value of the purchase before selling within five to seven years to repay investors.
This type of research shows the overall weakness of America's health care system, which focuses more on profit than health, said Colleen Grogan, a professor in the graduate program in Health Administration and Policy at the University of Chicago. Grogan was not involved in the studies, although she works with one of its authors.
The U.S. is one of the world's richest countries and "we invest the most in our health care system," Grogan said. "But all that money is going primarily into the pockets of private investors and private entities that run the system, instead of into the health care needs of U.S. citizens."
Private equity promises to bring innovation to medical care, but the lack of quality results raises questions about whether new initiatives are happening, Grogan said.
Patient safety advocate Leah Binder said she doesn't think private equity is the problem. To her, the new research shows that all hospitals need to do better.
"I don't see a lot of heroes in this study," said Binder, president and CEO of The Leapfrog Group, which represents employers and other health care purchasers interested in hospital safety. "Private equity should get their act together. So should everyone else. This is a story of failure nationwide."
Hospital-acquired infections fell nationwide after spiking during the pandemic, Leapfrog's recent research showed, but patient surveys found drops reported in “communication about medicines” and “responsiveness of hospital staff," which are often tied to preventable medical errors.
Preventable medical errors kill about 250,000 patients a year, according to studies.
Staff cuts may be one of the reasons quality has been declining, perhaps more abruptly at hospitals owned by private equity, said Song, an associate professor of health care policy and medicine at Harvard Medical School and a general internist at Massachusetts General Hospital.
To buy hospitals or medical practices, private equity firms take out loans. To repay the interest on those loans, they have to raise prices and cut costs and one way to do that is to cut staff, he said.
Binder agrees staffing is part of the patient safety problem. But she thinks it goes deeper than that.
Most health care in the United States is funded through what's called a "fee for service" system ‒ if you get a service, you or your insurance company pays a fee. If that service includes an error, a check is still cut. And then another check comes, to fix whatever mistake was made.
"That's a terrible financing system and it has created all these incentives to do things that are not in the best interest of the patient," Binder said.
Instead, doctors should get paid for providing value rather than specific services to patients, she said.
But some people and institutions who make a lot of money from the current system would stand to lose money under such a switch, so it's been talked about for decades without much changing.
"We are not delivering the top-quality care we're paying for," Binder said. "It's time for the health care system to own that challenge and address it. Now."
Karen Weintraub can be reached at kweintraub@usatoday.com.