Hospital Mergers and Acquisitions From 2010 to 2019: Creating a Valid Public Use Database.

Abstract

Objective: To create, analyze, and distribute the Strategic Hospital Mergers & Acquisitions (M&A) Database, a detailed resource of hospital M&As from 2010 to 2019.

Study setting and design: We conducted more than 2000 Internet searches to supplement, verify, and correct M&A identifications of American Hospital Association (AHA) survey data. We assessed the accuracy of the AHA survey and performed staggered difference-in-differences analyses to estimate the impact of measurement error on treatment effects capturing shifts in our measure of hospital market power.

Data sources and analytic sample: We analyzed 1537 M&A-related ownership changes from 2010 to 2019 from our analytic sample of 4896 unique acute care general hospitals or critical access hospitals derived from the AHA Annual Survey dataset.

Principal findings: The AHA survey dataset correctly identified the M&A deal completion year for only 40.1% of M&A-related ownership changes. The improved accuracy and granular treatment indicators of our database corrected for underestimations of the impact of hospital consolidation on hospital market power, yielding an effect estimate over 200% higher than the uncorrected data.

Conclusions: By reducing errors in hospital M&A identification, our database can enhance the quality of studies investigating the effects of hospital consolidation on healthcare access and health outcomes.