A Systematic Review: Landscape of Private Equity in Dermatology From Past to Present

Sung, Ching-Hwa; Salem, Secilia; Oulee, Aislyn; Yahia, Rayan; Mesinkovska, Natasha Atanaskova; Zachary, Christopher B.

doi:10.36849/jdd.6892

Cited by 3 publications

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“…Few academic studies have systematically evaluated PE in healthcare. Our findings are aligned with two recent reviews of PE activity as it relates to dermatology,2627 reporting substantial growth, market penetration, and operational changes in association with PE ownership. Our findings are also more broadly aligned with existing research on the financialization of local and global healthcare systems,909192939495 including a shift towards increasingly complex corporate structures and modes of governance driven in part by PE ownership 18969798…”

Section: Discussionsupporting

confidence: 89%

“… 21 22 However, the relatively nascent body of literature on PE ownership in healthcare remains disjointed, with studies ranging across different medical settings and academic disciplines such as sociology, health services research, and economics. Although several overviews have been published about PE ownership in healthcare 23 24 25 as well as two research reviews that focused on the growth of PE ownership and its impacts on dermatology, 26 27 no systematic reviews have been published that comprehensively evaluated the impacts of PE ownership across healthcare settings globally. If PE ownership becomes increasingly prevalent within and across health systems, it is imperative to understand its influence on healthcare delivery and whether it differs from other institutional arrangements and management strategies.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating trends in private equity ownership and impacts on health outcomes, costs, and quality: systematic review

Borsa

Bejarano

Ellen

et al. 2023

BMJ

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Objective To review the evidence on trends and impacts of private equity (PE) ownership of healthcare operators. Design Systematic review. Data sources PubMed, Web of Science, Embase, Scopus, and SSRN. Eligibility criteria for study selection Empirical research studies of any design that evaluated PE owned healthcare operators. Main outcome measures The main outcome measures were impact of PE ownership on health outcomes, costs to patients or payers, costs to operators, and quality. The secondary outcome measures were trends and prevalence of PE ownership of healthcare operators. Data synthesis Studies were classified as finding either beneficial, harmful, mixed, or neutral impacts of PE ownership on main outcome measures. Results across studies were narratively synthesized and reported. Risk of bias was evaluated using ROBINS-I (Risk Of Bias In Non-randomised Studies of Interventions). Results The electronic search identified 1778 studies, with 55 meeting the inclusion criteria. Studies spanned eight countries, with most (n=47) analyzing PE ownership of healthcare operators in the US. Nursing homes were the most commonly studied healthcare setting (n=17), followed by hospitals and dermatology settings (n=9 each); ophthalmology (n=7); multiple specialties or general physician groups (n=5); urology (n=4); gastroenterology and orthopedics (n=3 each); surgical centers, fertility, and obstetrics and gynecology (n=2 each); and anesthesia, hospice care, oral or maxillofacial surgery, otolaryngology, and plastics (n=1 each). Across the outcome measures, PE ownership was most consistently associated with increases in costs to patients or payers. Additionally, PE ownership was associated with mixed to harmful impacts on quality. These outcomes held in sensitivity analyses in which only studies with moderate risk of bias were included. Health outcomes showed both beneficial and harmful results, as did costs to operators, but the volume of studies for these outcomes was too low for conclusive interpretation. In some instances, PE ownership was associated with reduced nurse staffing levels or a shift towards lower nursing skill mix. No consistently beneficial impacts of PE ownership were identified. Conclusions Trends in PE ownership rapidly increased across almost all healthcare settings studied. Such ownership is often associated with harmful impacts on costs to patients or payers and mixed to harmful impacts on quality. Owing to risk of bias and frequent geographic focus on the US, conclusions might not be generalizable internationally. Systematic review registration PROSPERO CRD42022329857.

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