Hospital ownership and financial performance: what explains the different findings in the empirical literature?

Inquiry. 2007 Spring;44(1):41-68. doi: 10.5034/inquiryjrnl_44.1.41.

Abstract

This study applies meta-analytic methods to conduct a quantitative review of the empirical literature on hospital ownership since 1990. We examine four financial outcomes across 40 studies: cost, revenue, profit margin, and efficiency. We find that variation in the magnitudes of ownership effects can be explained by a study's research focus and methodology. Studies using empirical methods that control for few confounding factors tend to find larger differences between for-profit and not-for-profit hospitals than studies that control for a wider range of confounding factors. Functional form and sample size also matter. Failure to apply log transformation to highly skewed expenditure data yields misleadingly large estimated differences between for-profits and not-for-profits. Studies with fewer than 200 observations also produce larger point estimates and wide confidence intervals.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Efficiency, Organizational
  • Financial Management / economics*
  • Financial Management / organization & administration
  • Hospitals, Proprietary / economics*
  • Hospitals, Proprietary / organization & administration
  • Hospitals, Public / economics*
  • Hospitals, Public / organization & administration
  • Hospitals, Voluntary / economics*
  • Hospitals, Voluntary / organization & administration
  • Humans
  • Models, Statistical
  • Ownership*
  • Reproducibility of Results
  • United States