By Dr Jonathan Shurlock
Edited by Dr Ahmed El-Medany
A fascinating study in the BMJ has begun to unpick and explore the role of private equity in healthcare provision. Led by Alexandar Borsa (@alexander_borsa) and Professor Joseph Dov Bruch (@Joe_Bruch), the group carried out a systematic review of studies that evaluated private equity owned healthcare providers.
The primary outcome measure was the impact of private equity ownership on outcomes, costs, and quality. Studies were identified and then classified as demonstrating benefit, harm, mixed, or neutral impact on these outcome measures. 1,778 studies were identified through usual search techniques, with 55 meeting the author’s inclusion criteria. The included studies assessed healthcare providers from 8 different countries, predominantly the USA (47/55 studies). The studies assessed various settings including nursing home, hospital, and outpatient environments.
Private equity ownership was consistently associated with increased costs to either the patient or their healthcare payer (Health insurance provider etc.). The authors also found an association with mixed to harmful impact on quality of healthcare provision. Throughout all assessed studies there was no consistently beneficial impact found.
While the study highlights some concerning features of private equity involvement in healthcare provision, it predominantly includes USA based studies, where this has been a feature of their healthcare system for some time. UK based clinicians may feel this is not relevant or generalisable to their practice at present. In recent years however, there has been a steady increase in private equity purchasing of healthcare provision in the UK. The trend has been written about as far back as 2012 by the association representing private equity and venture capital in Britain. With this evolving relationship between private equity and healthcare provision in the UK, clinicians need to consider the implications of the above research findings on their practice and the shape of the NHS more generally, moving forwards.
See the full study here: https://www.bmj.com/content/382/bmj-2023-075244
