New study links hospital privatization to worse patient care

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A new review has concluded that privatized hospitals tend to provide poorer quality care after becoming publicly owned. The study, led by researchers at the University of Oxford, was published today in The Lancet Public Health.

Lead author Dr Benjamin Goodair, a postdoctoral researcher in the Department of Social Policy and Intervention at the University of Oxford, said: “This review challenges the justifications for the privatization of healthcare and concludes that the scientific support for to healthcare privatization is weak. In general, hospital privatization can reduce costs, but it does so at the expense of quality of care.”

The researchers conducted an evidence-based meta-analysis of 13 longitudinal studies, covering a range of high-income countries. Each study assessed the quality of patient care measures before and after the privatization of health services, both at the hospital and regional levels. The studies included measured indicators of quality of care that included staffing levels, patient mix by insurance type, number of services provided, physician workload, and patient health outcomes. such as avoidable hospitalizations.






Credit: University of Oxford

Increases in privatization generally corresponded to worse quality of care, with no studies included in the review finding unequivocally positive effects on health outcomes. In addition, hospitals that transitioned from publicly owned to privately owned status tended to earn higher profits. This was achieved primarily by reducing staffing levels and reducing the proportion of patients with limited health insurance coverage.

In general, privatization was associated with fewer cleaning staff employed per patient and higher rates of patient infections, and in some studies, higher levels of hospital privatization were associated with higher rates of preventable deaths. However, in some cases (eg Croatia) privatization brought some benefits for patient access, through more accurate appointments and new means of care, such as after-hours telephone calls.

According to the researchers, the results challenge the theory that privatization can improve the quality of health care by increasing competition in the market and allowing for a more flexible and patient-centered approach.

More research is now needed into the effects of privatization on other aspects of health care, including community, primary and ambulance services.

Co-author Professor Aaron Reeves, from the University of Oxford’s Department of Social Policy and Intervention, said: “Health care systems are under pressure from aging populations, constrained budgets and the of the COVID-19 pandemic and governments could see privatization as a single, simple solution to the pressures, but there is a risk that the pursuit of short-term reductions may come at the expense of long-term outcomes, as the “outsourcing services to the private sector does not seem to offer better both care and cheaper care.”

The countries included in the analysis were Canada, Croatia, England, Germany, Italy, South Korea, Sweden and the USA

More information:
The effect of privatization of health care on the quality of care, The Lancet Public Health (2024). DOI: 10.1016/S2468-2667(24)00003-3

Provided by the University of Oxford

Summons: New study links hospital privatization to worse patient care (2024, February 28) retrieved March 23, 2024 from https://medicalxpress.com/news/2024-02-links-hospital- privatization-worse-patient.html

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