Physician-owned Diseases often occur in US hospitals health care systemAccused of snatching up the most profitable operations from other hospitals while leaving them with the sickest patients and poorest patients. Congress has banned the opening of new ones.
But an independent study released on September 2 argued that physician-owned hospitals have gotten a bad rap. The study, published online by the British medical journal The BMJ, concluded that overall, physician-owned hospitals are not picking up patients or limiting themselves to the most attractive types of procedures and operations.
Some of these hospitals specialized in a narrow set of procedures, but they only treated 20 percent of patients who went to physician-owned hospitals, the study found. The rest demand care in doctor-owned hospitals that offer many services similar to those in community hospitals.
“General and physician-owned hospitals have roughly the same proportion of Medicaid patients and racial minorities and are similar to other hospitals in terms of quality of care,” said Massachusetts General lead author and clinical fellow. Hospital.
The 2010 federal health care law not only banned new doctor-owned hospitals, but also limited the development of existing ones. Legislation introduced in May The proposal to lift these restrictions in Congress has been opposed by the main industry group, the American Hospital Association.
The study disputes the subject over the past decade of research. In 2005, the Congressional Independent Medicare Payment Advisory Commission or MedPAC investigated 48 specialty physician-owned hospitals Found evidence That they took matters of easy and better payment. Inspector General of the Department of Health and Human Services Reported in 2008 Specialized hospitals owned by doctors often lack emergency rooms and adjoining staff who can respond to medical emergencies. Emergency-room hospitals provide care for more low-income patients and people with chronic diseases, such as heart failure, which are not as profitable as elective surgery.
Thomas Nickels, an executive of the Hospital Association, called the BMJ study “incomplete and somewhat flawed”. He said the researchers had not investigated whether physicians were more likely to refer patients to their own hospitals. Such self-referrals are one of the main reasons the AHA has asked Congress to uphold health law restrictions.
“They send patients to their hospital to get what they want and they don’t take others,” said Nickels. “These institutions are very profitable, and they are profitable because they are choosing which type of patients to take.”
But the new study concludes that physician-owned hospitals were mistaken for only those who specialize in narrow-type services. In doctor-owned hospitals, the researchers identified from data provided by Physician Hospitals of America, a trade group, 99 specialized hospitals, but the majority, 120, were general acute hospitals. Those hospitals had a higher number of sick patients and higher-income and lower-income patients than typical hospitals, even though both types were owned by doctors.
Together, patients in physicians-owned hospitals were slightly healthier than those where the doctors were not themselves, but had similar mortality rates and suffered similar illnesses.
The study’s senior author and professor at Harvard School of Public Health, Drs. Ashish Jha said, “Overall, if they are differences, they are small.” “There are huge differences between public hospitals and non-profit hospitals, but we are not all around banning non-profit hospitals.”
The study found that 6 percent of Medicare hospital admissions in the areas studied were in doctor-owned hospitals, suggesting that those facilities do not have a “meaningful impact” on the finances of other hospitals. “Our work shows that some major criticisms [physician-owned hospitals]The study states, in which they select more profitable patients, provide less value care, and endanger the financial viability of nearby hospitals, may no longer be valid.
President of Physician Hospitals of America, Dr. R. Blake Curd praised the study, saying that it supports that they have been debating it for years. “This is a great look at the physician-owned hospital industry as a whole,” said a hand surgeon from South Dakota. “You can’t picture us with a broad brush stroke, which is what the American Hospital Association is always trying to do.”
Legislation to lift the ban on new physician-owned hospitals is in the House, but Nickels said no companion bill has been introduced in the Senate. “There is little interest in the Senate to pursue it,” he said.
But Dahi said he hoped a Senate bill would be introduced and said the lawmakers were receptive. “It is right for the Congress to re-evaluate the policy decision taken in 2010,” he said.