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Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

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Surgical Quality at Rural Hospitals After Private Equity Acquisition.

Cody Lendon Mullens1,2,3, Mitchell Mead2,4, Mustafa Abid5

  • 1Department of Surgery, University of Michigan. Ann Arbor, MI.

Annals of Surgery
|May 25, 2026
PubMed
Summary

Private equity acquisition of rural hospitals was linked to worse surgical outcomes. This included increased 30-day mortality and complications, highlighting the need for ongoing monitoring of private equity

Keywords:
access to caregeneral surgeryprivate equityrural healthrural surgerysurgical quality

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Area of Science:

  • Healthcare Management
  • Surgical Quality Assessment
  • Rural Health Disparities

Background:

  • Private equity (PE) is increasingly acquiring healthcare facilities, raising concerns about patient care quality.
  • The impact of PE acquisition on surgical quality within rural hospitals remains understudied.

Purpose of the Study:

  • To investigate the association between private equity acquisition and surgical quality in rural hospitals.
  • To compare postoperative outcomes for common general surgery procedures in PE-acquired versus non-PE-acquired rural hospitals.

Main Methods:

  • Utilized Medicare data (2011-2020) for appendectomy, cholecystectomy, colectomy, and incisional hernia repair.
  • Employed a difference-in-differences framework, matching PE-acquired rural hospitals with similar non-acquired rural hospitals.
  • Primary outcome: 30-day postoperative mortality; secondary outcomes: complications, serious complications, and readmissions.

Main Results:

  • Private equity acquisition was associated with a statistically significant increase in 30-day mortality (1.1 pp, P=0.04).
  • Complications (2.5 pp, P=0.03) and serious complications (1.5 pp, P=0.02) also significantly increased post-acquisition.
  • These findings persisted despite controlling for hospital characteristics and patient demographics.

Conclusions:

  • Private equity acquisition of rural hospitals correlates with a decline in surgical quality metrics.
  • Continuous monitoring of private equity's influence on rural healthcare delivery is essential.