Hospital consolidation has been linked to a decline in inpatient pediatric services, according to a study published in JAMA Pediatrics. Joining a health system increases the likelihood of hospitals ceasing inpatient pediatric care, impacting access to services for children. Policymakers should consider this when evaluating proposed hospital mergers and acquisitions. Further research is needed to examine the effects of inpatient unit closures on pediatric care, the variations in consolidation types, and the impact on child health outcomes and costs.
A recent study published in JAMA Pediatrics suggests that policymakers should carefully consider the consequences of hospital consolidation on inpatient pediatric services when evaluating proposed mergers and acquisitions. Researchers from the University of Pittsburgh School of Medicine found that joining a health system was associated with a loss of inpatient pediatric services at hospitals, indicating that hospital consolidation can affect access to care for children.
Over the past few decades, there has been a trend of centralizing inpatient pediatric services, possibly due to the closure of pediatric units at small, rural hospitals. With the ongoing acceleration of hospital consolidation, the researchers aimed to investigate whether joining a hospital system leads to the closure of pediatric units as a cost-saving measure or provides an opportunity for small facilities to maintain these services.
The researchers gathered data from the American Hospital Association (AHA) annual surveys conducted between 2011 and 2020. They analyzed information from 5,104 hospitals, representing 46,841 hospital years. The findings revealed that the proportion of hospitals offering inpatient pediatric services declined from 41.5 percent to 32.6 percent during the study period.
The primary analysis focused on 1,088 hospitals, out of which 235 (21.6 percent) joined a hospital system during the study period. It was observed that hospitals that became part of a system were more likely to discontinue inpatient pediatric services within five years, with an adjusted odds ratio of 1.57. This association remained statistically significant when following up with hospitals after four years, but it was not as apparent in shorter follow-up durations.
These findings highlight how hospital consolidation worsens the already limited availability of inpatient pediatric services in the United States. Policymakers should take into account the potential loss of these services when assessing proposed hospital mergers and acquisitions, according to the researchers. Additionally, further research should explore the impact of inpatient unit closures on access to pediatric acute care, how the effects of consolidation vary based on the type of consolidation, and how hospital consolidation affects child health outcomes and costs.
Previous studies have reported diverse consequences of healthcare mergers and acquisitions. For instance, one study found that hospital mergers were associated with reduced mortality rates for conditions like myocardial infarction, heart failure, acute stroke, and pneumonia in rural hospitals. The American Hospital Association states that hospital mergers and acquisitions also lead to cost reductions, including operating expenses and revenue per admission.
However, it is worth noting that hospital mergers can potentially impede market competition and result in increased prices, as stated by America’s Health Insurance Plans (AHIP). Another study found that hospital acquisitions had no significant impact on quality of care measures, such as hospital readmissions and mortality rates.