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The number of non-profit hospitals converting to for-profit status has accelerated over the past decade. There is widespread concern that when hospitals convert, they will focus more on maximizing profits and improving payer mix, and less on quality of care or patient outcomes.
We used Medicare data from 2002 through 2010 to identify hospitals that converted to for-profit status and matched them to similar hospitals that did not convert. We used national Medicare inpatient data to examine whether conversion was associated with changes in quality of care, patient outcomes, and patient mix for acute myocardial infarction (MI).
Between 2002 and 2010, there were 216 hospitals that converted to for-profit status. We found that, compared to matched controls, hospitals that converted demonstrated no change in their process score for acute MI the year after conversion (Table). There were no differences in mortality rates for acute MI at converters compared to controls (results), or in readmission rates. There were no differences in the proportion of black or Hispanic patients at converters versus controls, and no difference in the proportion of care provided to the poor.
We found no evidence that conversions to for-profit status were associated with worsening quality, clinical outcomes, or access to care for acute MI. These findings may provide reassurance to those concerned that the recent increase in for-profit conversion will have deleterious effects on patient care.
|Outcome||Pre-conversion||Difference‡||Post-conversion||Difference‡||P for interaction*|
↵† Non-switching controls are matched on hospital size, teaching status, and hospital referral region.
↵‡ Difference indicates converter minus control.
↵* P value presented is for the difference in differences between pre- and post- for converters versus controls. DSH=Disproportionate Share, a measure of the proportion of hospital care provided to the poor.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Enhancing Value in Coronary Intervention and Myocardial Infarction Care
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1157M-95
- 2013 American College of Cardiology Foundation