Mark T L
MEDSTAT Group, Washington, DC 20008, USA.
Health Serv Res. 1999 Apr;34(1 Pt 1):83-101.
To examine percursors to private hospitals conversion, both from nonprofit status to for-profit status and from for-profit to nonprofit status, as well as the effect of hospital conversions on hospital profitability, efficiency, staffing, and the probability of closure.
The Health Care Financing Administration's Medicare Cost Reports and the American Hospital Association's Annual Survey of Hospitals.
Bivariate and multivariate analyses comparing conversion hospitals to nonconversion hospitals over time were conducted.
The study sample consisted of all private acute care hospital conversions that occurred from 1989 through 1992.
Hospitals that converted had significantly lower profit margins prior to converting than did nonconversion hospitals. This was particularly true for nonprofit to for-profit conversions. After converting, both nonprofit and for-profit hospitals significantly improved their profitability. Nonprofit to for-profit hospital conversions were associated with a decrease in the ratio of staff to patients. No association was found between for-profit to nonprofit conversion and staff-to-patient ratios. The difference seems partially attributed to the fact that nonprofit hospitals that converted had higher staff ratios than the industry average. For-profit to nonprofit hospital conversions were associated with an increase in the ratio of registered nurses to patients and administrators to patients, despite the fact that nonprofit and for-profit hospitals did not differ in these ratios.
The improvement in financial performance following hospital conversions may be a benefit to the community that policymakers want to consider when regulating hospital conversions.
研究私立医院转变的前兆，包括从非营利性转为营利性以及从营利性转为非营利性，同时研究医院转变对医院盈利能力、效率、人员配备和关闭可能性的影响。
医疗保健财务管理局的医疗保险成本报告以及美国医院协会的医院年度调查。
进行了双变量和多变量分析，比较了随着时间推移转变医院和未转变医院的情况。
研究样本包括1989年至1992年期间发生的所有私立急性病护理医院转变。
转变的医院在转变前的利润率显著低于未转变的医院。对于非营利性转为营利性的转变尤其如此。转变后，非营利性和营利性医院的盈利能力均显著提高。非营利性转为营利性的医院转变与医护比下降有关。营利性转为非营利性转变与医护比之间未发现关联。这种差异似乎部分归因于转变的非营利性医院的人员比例高于行业平均水平。营利性转为非营利性的医院转变与注册护士与患者之比以及管理人员与患者之比的增加有关，尽管非营利性和营利性医院在这些比例上并无差异。
医院转变后财务绩效的改善可能是一种对社区有益的情况，政策制定者在监管医院转变时需要考虑这一点。
