A new academic study has revealed alarming findings about rising death rates in emergency departments at U.S. hospitals that were acquired by private equity firms, compared to similar hospitals that remained under traditional management. The results highlight a clear link between aggressive cost-cutting strategies typically adopted by such firms and the decline in the quality of patient care.
The study was conducted by a joint research team from Harvard Medical School, the University of Pittsburgh, and the University of Chicago, with data collected over a ten-year period between 2009 and 2019. The results were published in the Annals of Internal Medicine on September 23 and later reported by Newsweek, drawing significant media attention in the United States.
Researchers compared more than one million emergency department visits and 121,000 intensive care unit (ICU) admissions in 49 private equity–owned hospitals with over six million emergency visits and 760,000 ICU admissions across 293 control hospitals not acquired by private equity firms. The analysis relied on Medicare claims data and official hospital cost reports.
Salary cuts and their impact on mortality
The study found that hospitals taken over by private equity firms implemented strict cost-cutting measures, most notably through reducing staff numbers and lowering wages. While these strategies are designed to generate quick financial returns for investors, they had direct consequences on patient safety and the quality of care.
According to the findings, mortality rates in emergency departments among Medicare beneficiaries rose by 13% after private equity takeovers—equivalent to seven additional deaths per 10,000 visits—compared to a baseline mortality rate of 52 deaths per 10,000 visits. One contributing factor, the researchers noted, was an increase in the number of critically ill patients being transferred to other hospitals due to reduced capacity and limited services after staffing cuts.
Speaking to Newsweek, Dr. Zirui Song, associate professor of health care policy at Harvard and a practicing internist at Massachusetts General Hospital, emphasized the seriousness of the results:
"We also found an 18% decrease in average emergency department salary expenses following acquisitions, which likely reduced both the capacity and the scope of services, and may directly explain the rise in mortality rates."
Intensive care units
In ICUs, the study documented a 16% reduction in salary expenditures. While the overall mortality rate within ICUs remained relatively unchanged, the researchers observed a significant shift: the sickest patients were increasingly transferred to other hospitals, while less critically ill patients who remained in ICU had shorter stays than before.
Broader implications
These findings suggest that when private equity firms acquire hospitals, structural changes often prioritize financial efficiency over medical quality. By aggressively reducing operating costs, these hospitals may inadvertently jeopardize patient outcomes and safety.
The study raises urgent questions about the role of private investment in healthcare and calls for stricter regulations to ensure that cost-cutting practices do not compromise patient care. It underscores the need for a balance between financial sustainability and the core mission of hospitals: saving lives and delivering high-quality, compassionate medical treatment.
