TOPLINE:Patients undergoing esophagectomy at private equity–acquired health centers have an increased risk for mortality, surgical complications, and failure to rescue than those undergoing the procedure at nonacquired health centers.
METHODOLOGY:The increasing acquisition of health systems by private equity in the United States raises concerns about healthcare quality and costs, particularly in the context of esophagectomy, a complex surgical procedure that demands substantial resources and expertise.A retrospective cohort study compared postoperative outcomes between private equity–acquired (identified using the Agency for Healthcare Research and Quality’s Compendium of US Health Systems) and nonacquired health centers among Medicare beneficiaries aged 65-99 years who underwent esophagectomy between October 2023 and March 2024.Postoperative outcomes included the 30-day mortality rate, occurrence of any complication and serious complications, failure to rescue, and 30-day readmission rate.A sensitivity analysis was performed to compare similarly low-volume private equity–acquired and nonacquired hospitals and included 2878 patients, of whom 337 underwent resection at private equity–acquired health centers.TAKEAWAY:In total, 9462 patients (mean age, 72.9 years; 73.7% men; 89.6% White) underwent elective esophagectomy, with 5.5% (n=517) treated at private equity–acquired health centers.Private equity–acquired health centers vs nonacquired health centers demonstrated a decreased annual esophagectomy case volume (median, 2 vs 7 procedures per year; P <.001 and a lower nurse-to-patient ratio vs p with patients who underwent esophagectomy at nonacquired health centers those receiving this treatment private equity had:82 higher odds of mortality experiencing any complication for serious complications failure to rescue rates were comparable between centers.the sensitivity analysis also favored treated showing greater likelihood practice: study findings suggest that poorer postoperative outcomes may be attributed characteristic structural differences associated acquisition the authors wrote. message from article is necessity keep an eye not only on but all complex surgical procedures among hospital types raise alarm if needed. either hospitals need invest in quality databases hire more staff educate perioperative care or they recognize inequity are providing cases aaron r. dezube md virginia litle wrote invited commentary. source:the led by jonathan e. williams department surgery university michigan ann arbor was published online jama surgery. limitations:the reliance medicare data limited generalizability younger populations. lack clinical granularity due use claims have affected assessment comorbidities complications. temporal ability assess changes over time. sources did provide comprehensive comparison institutional factors influencing patient care. disclosures:this supported grants national institutes cancer institute. some reported during conduct one author outside submitted work. two personal fees network as visual abstract editors created using several editorial tools including ai part process. human reviewed content before publication.>
Source : Medscape