Evaluation of costs and outcomes of physician-owned hospitals across common surgical procedures

Introduction: The Affordable Care Act introduced restrictions on the creation of new physician-owned hospitals (POH). We sought to define whether POH status was associated with differences in care.Methods: Patients undergoing one of ten surgical procedures were identified using Medicare Standard Ana...
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Introduction: The Affordable Care Act introduced restrictions on the creation of new physician-owned hospitals (POH). We sought to define whether POH status was associated with differences in care.Methods: Patients undergoing one of ten surgical procedures were identified using Medicare Standard Analytic Files. Patient and hospital-level characteristics and outcomes between POH and non-POH were compared.Results: Among 1,255,442 patients identified, 14,560 (1.2%) were treated at POH. A majority of POHs were in urban areas (n = 30, 90.9%) and none were in low socioeconomic status areas. Patients at POH were slightly younger (POH:72, IQR:68–77 vs. non-POH:73, IQR:69–79) and healthier (CCI; POH:2; IQR: 1–3 vs. non-POH: 3; IQR: 1–4). Patients at non-POH had higher odds of postoperative complications (OR:1.67, 95%CI:1.55–1.80) and slightly higher medical expenditures (POH:$11,347, IQR:$11,139-$11,936 vs. non-POH:$13,389, IQR:$11,381–$19,592).Conclusions: POH were more likely to be located in socioeconomic advantaged areas, treat healthier patients and have lower associated expenditures. Ausführliche Beschreibung