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Association of bond, market, operational, and financial factors with multi-hospital system bond issues
C E Carpenter1, M J McCue, J B Hossack
1Graduate Program in Health and Medical Services Administration, Widener University, Chester, PA 19013, USA.
Abstract:
Despite the growth of multi-hospital systems in the 1990s, their performance in the tax-exempt bond market has not been adequately evaluated. The purpose of this study is to compare bonds issued by multi-hospital systems to those issued by individual hospitals in terms of bond, market, operational, and financial characteristics. The study sample includes 2,078 newly issued, tax-exempt, revenue bonds between 1991 and 1997. The findings indicate that multi-hospital systems issued larger amounts of debt at a lower cost, were more likely to be insured, had higher debt service coverage and higher operating margins.