The effects of private equity ownership in U.S. nursing homes quality and financial performance: A systematic review

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-07-18 DOI:10.1016/j.healthpol.2025.105388

Gregory N. Orewa , Aizhan Karabukayeva , Rohit Pradhan , Itopa Jimoh , Robert Weech-Maldonado

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引用次数: 0

Abstract

Background

Private equity (PE) investment in U.S. nursing homes has increased significantly over the past two decades. The emergence of this novel ownership model has prompted concerns regarding its effects on nursing home performance, especially quality.

Objective

This systematic review examined the impact of PE ownership on U.S. nursing homes, focusing on quality of care and financial performance. The review was conceptually informed by agency theory and the structure-process-outcome (SPO) framework.

Methods

Following PRISMA guidelines, a systematic search across five databases identified 12 studies published between 2000 and 2024. Eligible studies examined the effects of PE ownership on nursing home quality or financial performance. Data were extracted and synthesized across these two dimensions.

Results

Across studies, PE ownership was linked to higher number of deficiencies, increased hospitalization rates, and higher mortality, although some improvements in care processes were noted. Financial outcomes showed initial financial gains but long-term challenges, primarily due to high debt loads.

Conclusions

Findings suggest that PE strategies may prioritize short-term profitability, which may compromise quality of care in some instances. These findings highlight the need for financial transparency, and reimbursement models that incentivize long-term quality.

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私募股权对美国养老院质量和财务绩效的影响：系统回顾

在过去的二十年里，私募股权（PE）对美国养老院的投资显著增加。这种新型所有权模式的出现引起了人们对其对养老院绩效，特别是质量的影响的关注。目的：本系统综述考察了私募股权对美国养老院的影响，重点关注护理质量和财务绩效。本研究在概念上以代理理论和结构-过程-结果（SPO）框架为依据。方法遵循PRISMA指南，对5个数据库进行系统检索，确定了2000年至2024年间发表的12项研究。合格的研究考察了私募股权对养老院质量或财务绩效的影响。在这两个维度上提取和合成数据。结果在所有研究中，尽管注意到护理过程的一些改进，但PE所有权与缺乏症数量增加、住院率增加和死亡率升高有关。财务结果显示最初的财务收益，但长期挑战，主要是由于高债务负担。结论：研究结果表明，PE策略可能优先考虑短期盈利能力，这可能在某些情况下损害护理质量。这些发现强调了财务透明度和激励长期质量的报销模式的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.