Private Equity Hospital Acquisition Associated With Decreased Staffing, Spending, Concerning Patient Outcomes

Background: Private equity firms now control several hundred hospitals. There has been little research on how private equity control impacts staffing and how this may be correlated with patient outcomes. This study focused on emergency departments (EDs) and ICUs, areas that are most sensitive to staffing due to the high acuity of illness. Objective: To examine hospital staffing and patient outcomes in EDs and ICUs before and after hospitals were acquired by private equity. Design: Matched difference-in-differences analysis. Methods: 49 hospitals that were acquired by private equity (treatment group), with 293 matched control hospitals, were compared. Treatment group hospitals had 1 to 3 years of pre-acquisition claims and 2 to 3 years of post-acquisition claims. Primary staffing outcomes were salary expenditure per ED or ICU bed day. Primary clinical outcomes were mortality, transfers, and ICU length of stay, assessed using Medicare claims. Results: Overall, this study analyzed 1,007 more...