Study: Esophagectomy outcomes worse at private equity hospitals

Editor's Note

A study published in JAMA Surgery revealed that hospitals owned by private equity firms had significantly worse outcomes for esophagectomy patients compared to non-acquired hospitals. As detailed in a January 2 report on the findings in MedPage Today, the analysis of over 9,000 cases highlights disparities in 30-day mortality, complications, and failure-to-rescue rates. Specific disparities include:

• 30-day mortality: 8.1% vs. 4.9% in non-acquired hospitals (OR 1.82, P=0.002).
• Serious complications: 17.5% vs. 14.3% (OR 1.35, P=0.03).
• Failure to rescue: 5.9% vs. 3.4% (OR 1.86, P=0.004).
• Any complication: 36.6% vs. 30.1% (OR 1.46, P=0.001).

The research also identified structural deficiencies, MedPage reports. For example, private equity hospitals had lower nurse-to-patient ratios (7.9 vs. 9.6, P<0.001), were less likely to be teaching hospitals (3.8% vs. 24.5%, P<0.001), and handled fewer annual esophagectomy cases (2 vs. 7, P<0.001). Researchers also pointed to ICU organization and multidisciplinary care as potential contributors to poorer outcomes, arguing that institutional factors beyond procedural volume play a significant role in influencing surgical success.  

The full report provides additional details on the study as well as accompanying commentary, which stresses the urgency of monitoring quality outcomes in private equity hospitals and suggests specific improvements.