Manheim L M, Shortell S M, McFall S
Center for Health Services and Policy Research, Northwestern University, Evanston, IL 60201.
Health Serv Res. 1989 Oct;24(4):461-84.
Much concern has been raised about the effect of "corporatization" of health through the expansion of investor-owned hospital chains. One method of expansion is through hospital acquisition. At issue is the question of the effect of acquisitions on expenses and on such patient care inputs as staffing levels. In this article, we examine the effect of acquisition by one investor-owned chain on hospital costs and staffing. Subsequent to acquisition, hospital costs increase and staffing decreases, relative to competitor hospitals. However, since investor-owned hospitals not recently acquired do not have higher cost levels than their competitors, the increase in costs appears to be due to factors associated with the acquisition itself rather than factors associated with being an investor-owned hospital. Under the retrospective payment system in effect at the time, revenues also were higher for acquired hospitals. Under prospective payment, increasing revenues has been more difficult, decreasing acquisition incentives.
人们对通过扩大投资者所有的连锁医院来实现医疗“公司化”的影响提出了诸多担忧。一种扩张方式是通过医院收购。关键问题在于收购对费用以及诸如人员配备水平等患者护理投入的影响。在本文中，我们研究了一家投资者所有的连锁机构进行收购对医院成本和人员配备的影响。收购后，与竞争医院相比，医院成本增加而人员配备减少。然而，由于近期未被收购的投资者所有的医院成本水平并不高于其竞争对手，成本增加似乎是由于与收购本身相关的因素，而非与作为投资者所有的医院相关的因素。在当时实行的回顾性支付系统下，被收购医院的收入也更高。在预期支付制度下，增加收入变得更加困难，这降低了收购的积极性。
