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Study: Care doesn't improve as hospitals acquire more physician practices

By Tauren Dyson

Feb. 13 (UPI) -- The integration of physicians and hospitals doesn't always mean better care, a study says.

On the contrary, vertical integration has actually led to limited results in lowering hospital readmission rates and overall patient satisfaction scores, according to research published this week in Medical Care Research and Review.

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"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," Vivian Ho, who runs Rice University's Center for Health and Biosciences and study co-author, said in a press release.

"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," Ho said.

The researchers examined data from the Centers for Medicare and Medicaid Services' Hospital Compare database between 2008 and 2015. They analyzed whether patient outcomes are determined by more hospital market concentration or vertical integration between hospitals and physician.

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When they launched the study, the researchers initially thought vertical integration would improve the patients quality of care. Instead, they found that integration lowers market competition, which leads to lower patient satisfaction.

They say that fewer options for patient care leads less incentive for hospitals to deliver good care.

"Although better patient experience may not always correlate with higher clinical quality, measuring quality based on patient perception is increasingly important as more consumers use online physician ratings and reviews of patient experience to select providers," said Marah Short, associate director of the institute's Center for Health and Biosciences and study co-author.

"Therefore, we need further research on the ability of patient satisfaction to reflect clinical quality, and if it does not, we need to develop and provide to patients better measures in terms that patients can understand and use," Short said.

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