Hospital privatization leads to lower quality care, study reveals

A new study concludes that privatized hospitals typically provide lower quality care after converting from public ownership. The study, led by researchers at the University of Oxford, was published today. lancet public health (Video summary is in the notes section).

This review challenges the legitimacy of healthcare privatization and concludes that the scientific support for healthcare privatization is weak. Overall, hospital privatization may reduce costs, but at the expense of quality of care. ”

Dr Benjamin Goodair, first author, Postdoctoral Researcher, Department of Social Policy and Intervention, University of Oxford

The researchers conducted a meta-analysis based on evidence from 13 longitudinal studies from a variety of high-income countries. Each study assessed the quality of health care provision for patients before and after health service privatization at the hospital or district level. The study included health care quality measures such as staffing levels, patient mix by insurance type, number of services provided, physician workload, and patient health outcomes such as avoidable hospitalizations. I am.

Key findings:

• Increased privatization generally coincides with a decline in the quality of health care, and no studies were included in the review that found a clear positive impact on health outcomes.
• Hospitals that converted from public to private ownership tended to have higher profits. This was accomplished primarily by reducing staffing levels and reducing the proportion of patients with limited health insurance coverage.
• Privatization generally corresponded to fewer cleaning staff being employed per patient and higher infection rates among patients.
• Several studies agree that higher levels of hospital privatization are associated with higher avoidable mortality rates.
• However, in some cases (e.g. Croatia), privatization has brought some benefits to patient access through new means of care delivery, such as more accurate appointments and after-hours telephone calls.

The findings cast doubt on the theory that privatization can improve the quality of health care by increasing market competition and enabling a more flexible, patient-centered approach, the researchers said.

Further research is needed into the impact of privatization on other aspects of health care, such as community care, primary services, and ambulance services.

Co-author Professor Aaron Reeves, from the University of Oxford’s School of Social Policy and Intervention, said: “Health systems are under pressure from aging populations, budget constraints and the fallout from the COVID-19 pandemic, and governments are There is a possibility that it will be affected in the future.” Look to privatization as a single simple solution to pressures. But seeking short-term cuts could come at the expense of long-term outcomes, as outsourcing services to the private sector is unlikely to provide both better and cheaper care. There are risks. ”

The countries included in the analysis were Canada, Croatia, the United Kingdom, Germany, Italy, South Korea, Sweden, and the United States.