Growth and impact of multiunit hospital systems

The growth of multiunit hospital systems (organizations that include two or more acute-care hospitals owned, leased, or managed by a single corporate entity) and their impact on health care are described. In 1970, there were fewer than 50 nongovernmental multiunit hospital systems in the United States. By 1981, this figure increased to 256; 53% of the systems included only two or three hospital units, while 13% included 11 or more units. Approximately one third of all nongovernmental hospitals in 1981 were included in multiunit systems. About 12% of the systems, which included 39% of the hospitals, were owned or operated by investor-owned firms. Multiunit hospital systems can improve the hospital industry's overall effectiveness and efficiency by achieving economies of scale and by developing hospital performance criteria and standards. In the future, the number and size of U.S. multiunit hospital systems most likely will continue to increase. The nation's multiunit hospital systems vary enormously in size and composition, as well as in their mission, goals, values, and approaches to governance and management.