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Hospital Ownership and Performance: An Integrative Research Review

  • Yu-Chu Shen, PhD

Although hospitals with different types of ownership have co-existed for a long time (i.e. owned by a for-profit corporation, a not-for-profit or publicly owned), the merit of having hospitals operating under one type of ownership vs. others has remained controversial. Theoretical arguments and political ideology aside, such controversy is not surprising given the diverse results from the empirical literature in this area. In the study to be presented, the researchers applied formal statistical methods of meta-analysis for compiling results from studies of hospital ownership between 1990 and 2004 to assess the main findings of the empirical literature on hospital ownership and performance. The researchers identified about 130 articles that can be grouped into the following categories of hospital performances: financial state, staffing, mortality and other patient outcomes, uncompensated care and other community benefits. For this Research in Progress seminar, Yu-Chu Shen will present the meta-analysis results of the financial measures. She will discuss whether there exists publication bias in this literature; to what extent the estimated effects of hospital ownership vary by study features (such as differences in sample size, state or region studied, years of data, sophistication of method used to disentangle ownership from other factors); and issues that arise when applying meta-analysis techniques to observational studies.