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Jonathan E Williams1, Sara L Schaefer1, Ryan C Jacobs2
1Department of Surgery, University of Michigan, Ann Arbor, Mich; Center for Healthcare Outcomes and Policy, Institute for Healthcare and Policy Innovation, University of Michigan, Ann Arbor, Mich.
私募股权收购的医院在肺部手术中死亡率和并发症率较高. 这些发现表明,这些机构的胸部外科护理可能存在质量问题.
科学领域:
- 医疗保健管理的管理
- 外科手术的结果
- 卫生经济学 卫生经济学
背景情况:
- 在美国,私募股权 (PE) 对医院的收购正在增加.
- 对于复杂的手术护理,特别是胸部手术,PE所有权对其质量的影响仍未得到充分研究.
研究的目的:
- 评估私募股权公司收购的美国医院胸部外科护理的质量.
- 为了比较在PE获得的医院和非获得的医院进行的选择性肺切除术的术后结果.
主要方法:
- 对接受选择性肺切除 (2016-2020) 的医疗保险受益人 (65-99岁) 的回顾性分析.
- 使用AHRQ健康系统汇编识别PE获得的医院.
- 使用后勤回归,对30天死亡率,并发症,未能救援,再接收和停留时间进行了风险调整的比较.
主要成果:
- 患有PE的医院患者的30天死亡率 (2.1%对1.9%),严重并发症 (8.1%对6.8%) 和30天再入院 (10.6%对9.9%) 较高.
- 患有PE的医院每年进行的肺切除手术较少 (平均4.2 vs 10.5).
- 在患有PE的医院,术后停留时间较长 (5.9天而不是5.3天).
结论:
- 私募股权收购可能与胸部外科手术的护理质量较差有关.
- 获得PE的医院内的结构因素可能解释观察到的结果差异.
- 需要进一步研究PE所拥有的医疗机构的专科外科护理.
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