Study: Hospital Merger in NY Improved Quality, Outcomes

January 10, 2022 - Health outcomes and satisfaction rates at NYU Langone Hospital–Brooklyn, previously known as Lutheran Medical Center, have improved after a hospital merger deal with NYU Langone in 2016, according to a recent study published in JAMA Network Open. 

The study findings showed that in-hospital mortality rates dropped by 33 percent, highlighting that a full-integration approach to a hospital merger is associated with improved outcomes.

Using data from 122,348 patients in the pre-merger and 58,904 patients in the post-merger, researchers analyzed in-hospital mortality, in-hospital readmissions, and hospital-acquired infections, including catheter-associated urinary tract infections and central line-associated bloodstream infections. They also studied patient experience scores.

Researchers discovered that the in-hospital mortality rate dropped from a mean of 2.6 percent pre-merger to 1.9 percent post-merger. 

In addition, there were fewer central line infections per 1,000 catheter days, with a 39 percent improvement.

The rate of catheter-associated urinary tract infections per 1,000 discharges also improved by 33 percent.

The likelihood of patients recommending NYU Langone Hospital-Brooklyn increased, too. NYU Langone Hospital-Brooklyn serves one of the highest Medicaid populations in the country, with Medicare and Medicaid accounting for 80 percent of insurance coverage. 

However, the findings showed a decrease in hospital admission with an average of 9.5 percent pre-merger to 7.2 percent post-merger. 

“Our study shows that when a hospital merger has a comprehensive strategy, focuses on quality, and involves meaningful operational integration, outcomes can be significantly improved at the acquired hospital,” lead study author Erwin C. Wang, MD, assistant professor in the Department of Medicine at NYU Grossman School of Medicine and medical director of the nurse practitioner service at NYU Langone Hospital-Brooklyn said in the press release.

The study findings contrasted recent studies that suggested the majority of mergers do not lead to improved quality or safety. 

“The vast majority of the existing research on hospital mergers finds that these transactions are likely strictly financially motivated and thus do not involve true operational integration and did not improve quality outcomes,” Wang stated.

Since 2009, the rate of hospital consolidation has nearly doubled. Evidence suggests an overall negative effect of mergers on quality. Prior studies have indicated that hospital mergers increase the overall mortality rate. In addition, these studies showed that mergers worsen patient experiences and decrease readmission rates.

However, researchers stated that most hospital mergers show a lack of integration in management, culture, and data systems.

“By focusing on improving quality, this merger led to an impressive shift in quality and safety metrics, most notably a significantly lower mortality rate,” Bret J. Rudy, MD, senior author of the study and senior vice president and chief of hospital operations at NYU Langone Hospital-Brooklyn. “Importantly, our results differ from the existing literature that has shown hospital consolidations have generally failed to improve quality.”