Physician-hospital integration does not improve care quality, study says

As hospitals acquire physician practices and physician organizations grow, this physician-hospital integration did not improve care on several quality measures, according to a study published in Medical Care Research and Review.

The researchers, from Houston-based Rice University, analyzed information from the CMS Hospital Compare database for 2008 to 2015. They looked at readmission rates, patient satisfaction scores and process of care measurements that assess how well a hospital gives care to its patients.

They used this information to test whether patient outcomes are influenced by greater hospital market concentration or vertical integration between hospitals and physicians.

Before starting the study, the researchers hypothesized that decreased fragmentation, or better coordination among a patient's primary care physician, specialists and admitting and attending hospital physicians, may improve patient care. However, they found this vertical integration has a limited effect on care quality.

"The government requires that hospitals report on a wide variety of quality measures, such as practice of preventive care for surgical patients, whether their doctor or nurse communicated well, or whether the patient would recommend the hospital to others," said study author Vivian Ho, PhD.

"Physician-hospital integration did not improve the quality of care for the overwhelming majority of these measures. If patient welfare doesn't improve after integration, there may be other reasons why physicians and hospitals are forming closer relationships — perhaps to raise profits."

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