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For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study

For-profit hospitals’ market share has increased in many nations over recent decades. Previous studies suggest that their growth is not attributable to superior performance on access, quality of care, or efficiency. We analyzed other factors that we hypothesized may contribute to the increasing role...

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Autores principales: Jeurissen, Patrick P. T., Kruse, Florien M., Busse, Reinhard, Himmelstein, David U., Mossialos, Elias, Woolhandler, Steffie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756069/
https://www.ncbi.nlm.nih.gov/pubmed/33107779
http://dx.doi.org/10.1177/0020731420966976
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author Jeurissen, Patrick P. T.
Kruse, Florien M.
Busse, Reinhard
Himmelstein, David U.
Mossialos, Elias
Woolhandler, Steffie
author_facet Jeurissen, Patrick P. T.
Kruse, Florien M.
Busse, Reinhard
Himmelstein, David U.
Mossialos, Elias
Woolhandler, Steffie
author_sort Jeurissen, Patrick P. T.
collection PubMed
description For-profit hospitals’ market share has increased in many nations over recent decades. Previous studies suggest that their growth is not attributable to superior performance on access, quality of care, or efficiency. We analyzed other factors that we hypothesized may contribute to the increasing role of for-profit hospitals. We studied the historical development of the for-profit hospital sector across 4 nations with contrasting trends in for-profit hospital market share: the United States, the United Kingdom, Germany, and the Netherlands. We focused on 3 factors that we believed might help explain why the role of for-profits grew in some nations but not in others: (1) the treatment of for-profits by public reimbursement plans, (2) physicians’ financial interests, and (3) the effect of the political environment. We conclude that access to subsidies and reimbursement under favorable terms from public health care payors is an important factor in the rise of for-profit hospitals. Arrangements that aligned financial incentives of physicians with the interests of for-profit hospitals were important in stimulating for-profit growth in an earlier era, but they play little role at present. Remarkably, the environment for for-profit ownership seems to have been largely immune to political shifts.
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spelling pubmed-77560692021-01-08 For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study Jeurissen, Patrick P. T. Kruse, Florien M. Busse, Reinhard Himmelstein, David U. Mossialos, Elias Woolhandler, Steffie Int J Health Serv VII. The Causes of the Growth of For-Profit Hospitals in the US, UK, Germany and the Netherlands For-profit hospitals’ market share has increased in many nations over recent decades. Previous studies suggest that their growth is not attributable to superior performance on access, quality of care, or efficiency. We analyzed other factors that we hypothesized may contribute to the increasing role of for-profit hospitals. We studied the historical development of the for-profit hospital sector across 4 nations with contrasting trends in for-profit hospital market share: the United States, the United Kingdom, Germany, and the Netherlands. We focused on 3 factors that we believed might help explain why the role of for-profits grew in some nations but not in others: (1) the treatment of for-profits by public reimbursement plans, (2) physicians’ financial interests, and (3) the effect of the political environment. We conclude that access to subsidies and reimbursement under favorable terms from public health care payors is an important factor in the rise of for-profit hospitals. Arrangements that aligned financial incentives of physicians with the interests of for-profit hospitals were important in stimulating for-profit growth in an earlier era, but they play little role at present. Remarkably, the environment for for-profit ownership seems to have been largely immune to political shifts. SAGE Publications 2020-10-27 2021-01 /pmc/articles/PMC7756069/ /pubmed/33107779 http://dx.doi.org/10.1177/0020731420966976 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle VII. The Causes of the Growth of For-Profit Hospitals in the US, UK, Germany and the Netherlands
Jeurissen, Patrick P. T.
Kruse, Florien M.
Busse, Reinhard
Himmelstein, David U.
Mossialos, Elias
Woolhandler, Steffie
For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study
title For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study
title_full For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study
title_fullStr For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study
title_full_unstemmed For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study
title_short For-Profit Hospitals Have Thrived Because of Generous Public Reimbursement Schemes, Not Greater Efficiency: A Multi-Country Case Study
title_sort for-profit hospitals have thrived because of generous public reimbursement schemes, not greater efficiency: a multi-country case study
topic VII. The Causes of the Growth of For-Profit Hospitals in the US, UK, Germany and the Netherlands
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756069/
https://www.ncbi.nlm.nih.gov/pubmed/33107779
http://dx.doi.org/10.1177/0020731420966976
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