The impact of private equity acquisition of US hospitals on patient outcomes: A systematic review.

Abstract

Private equity (PE) firms are increasingly acquiring US hospitals. While PE ownership may infuse capital and managerial expertise, restructuring by organizations with limited patient-care experience raises safety concerns. The effect of PE ownership on hospital outcomes remains poorly defined. This study evaluated the association between PE hospital acquisition and patient outcomes. To investigate the impact of private equity aquisition of hospitals on patient outcomes. A systematic search of PubMed and Web of Science (inception to March 2026) was conducted in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines using terms related to "private equity," "hospital," "mortality," and "complications." Eligible studies were US observational or quasi-experimental analyses comparing outcomes between PE-acquired and nonacquired hospitals. Eight studies published from 2010 to 2026 met the inclusion criteria. PE ownership was consistently associated with higher mortality, complication, and failure-to-rescue rates among surgical patients, while findings for readmissions and length of stay were mixed across studies. Additional findings included more hospital-acquired infections and fewer discharges home. PE acquisition of US hospitals may be associated with worse patient outcomes, particularly in high-acuity surgical care. Greater ownership transparency, regulatory oversight, and standardized quality safeguards are needed to protect patient safety.