Hospital ownership and quality of care: what explains the different results?

Abstract

Does quality of care systematically differ among government-owned, private not-for-profit, and for-profit hospitals? A large empirical literature provides conflicting evidance. Through quantitative review of 46 studies since 1990, we find that several study features that can explain divergent results: analytic methods, disease studied, and data sources. For unprofitable care, how studies handle market competition and regional differences account for substantial variation. Policymakers should be aware that differences in results appear to arise predominately from differences between studies' analytic methods. Moreover, conventional methods of meta-analysis synthesis should be applied with great caution given the considerable overlap among studied hospitals.