Study Shows Improved Quality of Care After Mergers

Sarasota, FL (WorkersCompensation.com) – Managing the care of injured rural workers comes with its own set of challenges; however, a study published in last month’s edition of JAMA suggests you might want to review hospital ownership when considering care.

Rural hospitals have been hit hard the last couple of years with multiple closures. In an already weakened healthcare system, the pandemic initially created access to care issues with reduced capacity protocols, and as a result, less revenue. Now, in the face of labor shortages, hospitals are once again seeing access to care issues that will ultimately have a financial impact. In fact, the total loss is estimated at over $54 billion by the end of the year from over a third of the hospitals in the country. 

One way that rural hospitals have survived the ups and downs of the industry has been through mergers and acquisitions. Merging with a larger healthcare entity allows them to not only pool resources, but gives them a voice with payers that they may not otherwise have on their own. While it’s most often a strategy to stay in business, such hospital deals have not come without criticism with many citing high pricing and lower quality of care.

Researchers set out to determine whether mergers really did have any impact on the quality of care of patients treated at rural hospitals. Using zip codes to narrow the list of hospitals, the researchers used the American Hospital Association’s Annual Survey to determine which hospitals had merged from 2009 to 2016. The researchers then reviewed discharge data from 2008 to 2018 for heart, gastric, orthopedic, and respiratory cases. The researchers reviewed data from 172 merged hospitals and 266 comparison hospitals. Records for the merged hospital set included 303,747 medical stays, and 175,970 surgical stays. The records reviewed for the comparison hospitals included 461,092 medical stays, and 278,070 surgical stays.

The researchers found that inpatient mortality rates for heart attacks decreased from 9.4 percent prior to the merger, to 5 percent after the merger. In the comparison hospitals, during the same period time, the rate dropped from 7.9 percent to 6.3 percent. The researchers found the same improvement 4 years post-merger. In fact, the level of mortality for heart attacks continued to drop to 4.3 percent. Overall, the researchers found the mortality rates for heat attack, stroke, and pneumonia steadily decreased. The mortality rates for gastric and hip fracture cases however, remained stable. Complications from elective surgeries showed no increase in both sets of hospitals.

As to the decrease in mortality rates, the researchers speculated that the mergers had allowed the hospitals to adopt more defined clinical pathways, and allowed access to cutting edge technology.

Share This Article: