For-profit hospitals have higher readmission rates for patients across six major diseases compared to nonprofit or public facilities, according to a University of Chicago study published in PLOS ONE on Tuesday.
The study analyzed data for patients suffering from six major and common diseases from 2012 to 2015: heart attack, heart failure, coronary artery bypass surgery, pneumonia, chronic obstructive pulmonary disease and total hip or knee replacement surgery. Researchers focused specifically on the ownership and profit motives of the hospitals and found that, in each category, for-profit hospitals had the highest mean and median readmission ratios. Geographic location of the facility was not a factor.
In light of their findings, the authors of the study urged policymakers to "mitigate any potential risks in the quality of patient care arising from unintended revenue pressure in healthcare institutions."
Readmission rates are a measure of cost and quality of services for American hospitals, and lowering them is an effective way to dually control the skyrocketing cost of healthcare and improve patient care.
A 2011 report published in the New England Journal of Medicine found that roughly one-fifth of Medicare beneficiaries discharged from a hospital were re-hospitalized within 30 days, costing the government an estimated $17.4 billion annually. A 2014 study identified that anywhere from 10-50% of all such readmissions were potentially preventable.
Cutting down on such preventable re-hospitalizations should be a focus for hospitals and for the administration, experts say.
For-profit hospitals are owned by investors and shareholders with profit motives, unlike government-owned and nonprofit institutions that deliver healthcare through public funding or without official profit incentivization. Though the study didn't blame profit incentives specifically, it attributed the underperformance of for-profit facilities to several factors — chief among them stakeholders' profit incentives. Another potential culprit was the difference in patient insurance portfolios between operations.
"It is remarkable to see such clear data in a study like this," said Andrew Boyd, one of the study's authors and associate professor of biomedical and health information sciences at the University of Illinois at Chicago College of Applied Health Sciences, in a corresponding release.
As healthcare markets and providers continue to consolidate, the report should give policymakers and antitrust regulators pause.
"This study shows an important national trend to which policymakers, health care providers, researchers and patients should pay attention, especially in light of a changing healthcare landscape marked by discussions on reimbursement rates and network consolidations, which are occurring across all types of hospitals," Boyd said.
The study analyzed readmission ratios from the national Hospital Readmission Reduction Program and sourced hospital ownership type from CMS.