Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals

<p>Abstract</p> <p>Background</p> <p>There is growing concern certain not-for-profit hospitals are not providing enough uncompensated care to justify their tax exempt status. Our objective was to compare the amount of uncompensated care provided by not-for-profit (NFP),...

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Main Authors: Vaughan-Sarrazin Mary S, Popescu Ioana, Bayman Levent, Cram Peter, Cai Xueya, Rosenthal Gary E
Format: Article
Language:English
Published: BMC 2010-04-01
Series:BMC Health Services Research
Online Access:http://www.biomedcentral.com/1472-6963/10/90
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author Vaughan-Sarrazin Mary S
Popescu Ioana
Bayman Levent
Cram Peter
Cai Xueya
Rosenthal Gary E
author_facet Vaughan-Sarrazin Mary S
Popescu Ioana
Bayman Levent
Cram Peter
Cai Xueya
Rosenthal Gary E
author_sort Vaughan-Sarrazin Mary S
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>There is growing concern certain not-for-profit hospitals are not providing enough uncompensated care to justify their tax exempt status. Our objective was to compare the amount of uncompensated care provided by not-for-profit (NFP), for-profit (FP) and government owned hospitals.</p> <p>Methods</p> <p>We used 2005 state inpatient data (SID) for 10 states to identify patients hospitalized for three common conditions: acute myocardial infarction (AMI), coronary artery bypass grafting (CABG), or childbirth. Uncompensated care was measured as the proportion of each hospital's total admissions for each condition that were classified as being uninsured. Hospitals were categorized as NFP, FP, or government owned based upon data obtained from the American Hospital Association. We used bivariate methods to compare the proportion of uninsured patients admitted to NFP, FP and government hospitals for each diagnosis. We then used generalized linear mixed models to compare the percentage of uninsured in each category of hospital after adjusting for the socioeconomic status of the markets each hospital served.</p> <p>Results</p> <p>Our cohort consisted of 188,117 patients (1,054 hospitals) hospitalized for AMI, 82,261 patients (245 hospitals) for CABG, and 1,091,220 patients for childbirth (793 hospitals). The percentage of admissions classified as uninsured was lower in NFP hospitals than in FP or government hospitals for AMI (4.6% NFP; 6.0% FP; 9.5% government; P < .001), CABG (2.6% NFP; 3.3% FP; 7.0% government; P < .001), and childbirth (3.1% NFP; 4.2% FP; 11.8% government; P < .001). In adjusted analyses, the mean percentage of AMI patients classified as uninsured was similar in NFP and FP hospitals (4.4% vs. 4.3%; P = 0.71), and higher for government hospitals (6.0%; P < .001 for NFP vs. government). Likewise, results demonstrated similar proportions of uninsured patients in NFP and FP hospitals and higher levels of uninsured in government hospitals for both CABG and childbirth.</p> <p>Conclusions</p> <p>For the three conditions studied NFP and FP hospitals appear to provide a similar amount of uncompensated care while government hospitals provide significantly more. Concerns about the amount of uncompensated care provided by NFP hospitals appear warranted.</p>
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spelling doaj.art-0972a7708e2549a986fd786f16fba5972022-12-21T21:19:21ZengBMCBMC Health Services Research1472-69632010-04-011019010.1186/1472-6963-10-90Uncompensated care provided by for-profit, not-for-profit, and government owned hospitalsVaughan-Sarrazin Mary SPopescu IoanaBayman LeventCram PeterCai XueyaRosenthal Gary E<p>Abstract</p> <p>Background</p> <p>There is growing concern certain not-for-profit hospitals are not providing enough uncompensated care to justify their tax exempt status. Our objective was to compare the amount of uncompensated care provided by not-for-profit (NFP), for-profit (FP) and government owned hospitals.</p> <p>Methods</p> <p>We used 2005 state inpatient data (SID) for 10 states to identify patients hospitalized for three common conditions: acute myocardial infarction (AMI), coronary artery bypass grafting (CABG), or childbirth. Uncompensated care was measured as the proportion of each hospital's total admissions for each condition that were classified as being uninsured. Hospitals were categorized as NFP, FP, or government owned based upon data obtained from the American Hospital Association. We used bivariate methods to compare the proportion of uninsured patients admitted to NFP, FP and government hospitals for each diagnosis. We then used generalized linear mixed models to compare the percentage of uninsured in each category of hospital after adjusting for the socioeconomic status of the markets each hospital served.</p> <p>Results</p> <p>Our cohort consisted of 188,117 patients (1,054 hospitals) hospitalized for AMI, 82,261 patients (245 hospitals) for CABG, and 1,091,220 patients for childbirth (793 hospitals). The percentage of admissions classified as uninsured was lower in NFP hospitals than in FP or government hospitals for AMI (4.6% NFP; 6.0% FP; 9.5% government; P < .001), CABG (2.6% NFP; 3.3% FP; 7.0% government; P < .001), and childbirth (3.1% NFP; 4.2% FP; 11.8% government; P < .001). In adjusted analyses, the mean percentage of AMI patients classified as uninsured was similar in NFP and FP hospitals (4.4% vs. 4.3%; P = 0.71), and higher for government hospitals (6.0%; P < .001 for NFP vs. government). Likewise, results demonstrated similar proportions of uninsured patients in NFP and FP hospitals and higher levels of uninsured in government hospitals for both CABG and childbirth.</p> <p>Conclusions</p> <p>For the three conditions studied NFP and FP hospitals appear to provide a similar amount of uncompensated care while government hospitals provide significantly more. Concerns about the amount of uncompensated care provided by NFP hospitals appear warranted.</p>http://www.biomedcentral.com/1472-6963/10/90
spellingShingle Vaughan-Sarrazin Mary S
Popescu Ioana
Bayman Levent
Cram Peter
Cai Xueya
Rosenthal Gary E
Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals
BMC Health Services Research
title Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals
title_full Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals
title_fullStr Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals
title_full_unstemmed Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals
title_short Uncompensated care provided by for-profit, not-for-profit, and government owned hospitals
title_sort uncompensated care provided by for profit not for profit and government owned hospitals
url http://www.biomedcentral.com/1472-6963/10/90
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AT popescuioana uncompensatedcareprovidedbyforprofitnotforprofitandgovernmentownedhospitals
AT baymanlevent uncompensatedcareprovidedbyforprofitnotforprofitandgovernmentownedhospitals
AT crampeter uncompensatedcareprovidedbyforprofitnotforprofitandgovernmentownedhospitals
AT caixueya uncompensatedcareprovidedbyforprofitnotforprofitandgovernmentownedhospitals
AT rosenthalgarye uncompensatedcareprovidedbyforprofitnotforprofitandgovernmentownedhospitals