Health Affairs, 2025
After the buyout, more deaths after surgery
After private equity firms bought hospitals, 30-day death rates after four common operations rose 2.7 percentage points compared with similar hospitals.
Summary
The study compared 67 hospitals acquired by private equity with 634 matched control hospitals, among fee-for-service Medicare beneficiaries 65 and older having appendectomy, cholecystectomy, colectomy or incisional hernia repair, 2011–20.
The rise appeared to be driven by failure to rescue. The death rate among patients who had a complication rose 3.9 percentage points, while complication rates did not change significantly. The mortality increase was concentrated in unplanned (emergency) operations, with no significant change for planned ones.
Death rates after surgery rose after private equity acquisition; beforehand they did not differ significantly from similar hospitals
Change in 30-day postoperative mortality vs. similar hospitals, in percentage points
Quarters relative to acquisition
| Quarter | Estimate | 95% CI lower | 95% CI upper |
|---|---|---|---|
| −8 | 1.05 | −1.03 | 3.13 |
| −7 | −0.87 | −3.29 | 1.54 |
| −6 | −0.96 | −3.24 | 1.33 |
| −5 | −0.51 | −2.61 | 1.58 |
| −4 | −1.04 | −3.97 | 1.89 |
| −3 | 0.50 | −2.61 | 3.61 |
| −2 | 0.83 | −2.32 | 3.99 |
| −1 | 0.35 | −2.51 | 3.21 |
| 0 | 4.00 | 1.60 | 6.40 |
| +1 | 2.74 | 0.69 | 4.80 |
| +2 | 2.52 | 0.82 | 4.22 |
| +3 | 1.99 | −0.28 | 4.26 |
| +4 | 2.33 | −0.03 | 4.69 |
| +5 | 1.75 | −0.51 | 4.01 |
| +6 | 3.43 | 1.32 | 5.54 |
| +7 | 2.60 | 0.57 | 4.62 |
| +8 | 3.10 | 0.60 | 5.59 |
Event-study (difference-in-differences) estimates of 30-day postoperative mortality at 67 hospitals acquired by private equity versus 634 matched control hospitals, by quarter relative to acquisition. Points are estimates; lines are 95% confidence intervals. Fee-for-service Medicare beneficiaries 65 and older having appendectomy, cholecystectomy, colectomy or incisional hernia repair, 2011–20. Source: Diaz A, Mead M, Rohde S, et al. Health Aff (Millwood) 2025;44(5):554–562, Exhibit 2. doi:10.1377/hlthaff.2024.01102. Redrawn by the lab from the study’s estimates.
Read the study
Diaz A, Mead M, Rohde S, Kunnath N, Dimick JB, Ibrahim AM. Hospitals Acquired By Private Equity Firms: Increased Postoperative Mortality For Common Inpatient Surgeries. Health Aff (Millwood). 2025;44(5):554–562. doi:10.1377/hlthaff.2024.01102
Data and how to cite
Download the data (CSV): postoperative mortality by quarter, Health Affairs 2025
The values plotted above: postoperative mortality by quarter, Health Affairs 2025.
How to cite: Diaz A, Mead M, Rohde S, Kunnath N, Dimick JB, Ibrahim AM. Hospitals Acquired By Private Equity Firms: Increased Postoperative Mortality For Common Inpatient Surgeries. Health Aff (Millwood). 2025;44(5):554–562. doi:10.1377/hlthaff.2024.01102