SOURCE: University of North Texas

April 16, 2012 06:00 ET

According to a Study Published in Health Affairs, Physician-Ownership of Cardiac Hospitals Linked to Disparities in Mortality Following Angioplasty

FORT WORTH, TX--(Marketwire - Apr 16, 2012) - Physician owners tout the lower mortality rates in their own cardiac, specialty hospitals. Yet a study published in the April issue of Health Affairs found that, for patients treated with coronary angioplasty, these same physicians have offsetting higher mortality rates for patients admitted to noncardiac hospitals. Patients with the best insurance were admitted to the cardiac hospital while Medicaid, uninsured, and minority patients were treated at the noncardiac hospital. The outstanding results reported by some cardiac hospitals may have less to do with physician skills than with the cream skimming of the more profitable patients to facilities in which they have an ownership interest.

By treating low-risk patients at the cardiac hospital and high-risk patients at the noncardiac hospital, the reported quality outcomes for both hospitals were found to be suspect. Even after accounting for differences in physician training and experience, mortality rates were more than three times higher for patients who were not admitted to the cardiac hospitals.

This study highlights the conflicts of interests that arise when physicians become part-owners in hospitals. Physician owners have an incentive to treat low-risk, profitable patients at their own facility while referring less profitable and more complicated cases to the community hospital. "We already know there is significant variation in mortality between high-performing and low-performing hospitals. What is new about this study is the finding that such differences persist even when the cardiologist is the same in both hospitals. Patients typically choose a physician first and then rely on their physician to decide on the hospital. The patient may not even realize that this decision could have a major impact on their risk of a bad outcome and that not everyone is selected for treatment at the 'best' hospital," said Dr. Liam O'Neill, lead author of the study, who is an associate professor at the School of Public Health at the University of North Texas in Fort Worth.

The study was based on hospital data collected by the Texas Department of State Health Services and included more than 210,000 angioplasties performed at Texas hospitals during 2004 - 2007. The study's co-author is Dr. Arthur Hartz, who is a professor of Internal Medicine at the University of Utah School of Medicine.

Abstract can be found here:

http://content.healthaffairs.org/content/31/4/806.abstract

Contact Information