Patient deaths increased in the emergency rooms of hospitals that were bought by private equity firms

A new study in Annals of Internal Medicine reports that patient deaths in emergency departments rose 13% after hospitals were taken over by private equity firms, compared with similar hospitals that were not acquired.

The research examined hospital outcomes over a decade, building on earlier findings that linked private equity ownership in health care to worse patient results and higher costs.

According to Dr. Zirui Song, co-author and associate professor of health care policy and medicine at Harvard Medical School, the increased mortality is likely tied to staffing cuts. The study showed that following private equity acquisitions, full-time hospital staff fell by an average of 11.6% relative to non–private equity hospitals, while salary spending in emergency departments dropped 18% and in intensive care units 16%.

“Most hospital care in the U.S. remains face-to-face, human, and labor-intensive, especially in emergency departments and ICUs,” Song said. “When staffing is cut this deeply in such sensitive areas, patient harm — including deaths — can plausibly follow.”

The study analyzed 1 million Medicare emergency visits at 49 hospitals purchased by private equity between 2009 and 2019, comparing outcomes with over 6 million visits at 293 matched hospitals of similar size and geography not owned by private equity.

Co-authors include José R. Zubizarreta of Harvard, Dr. Sneha Kannan of the University of Pittsburgh, Joseph Dov Bruch of the University of Chicago, and Dr. Jennifer Stevens of Beth Israel Deaconess Medical Center in Boston.

Song noted this study differs from earlier work that focused on admitted patients. “Many more patients enter emergency departments than are admitted into hospital wards,” he said. “This research looks closely at a patient population that hasn’t been studied in this depth before.”