title: Effects of physician-owned specialized facilities in health care: a systematic review.
abstract: BACKGROUND
  Multiple studies have investigated physician-owned specialized facilities (specialized hospitals and ambulatory surgery centres). However, the evidence is fragmented and the literature lacks cohesion.
  
  
  OBJECTIVE
  To provide a comprehensive overview of the effects of physician-owned specialized facilities by synthesizing the findings of published empirical studies.
  
  
  METHODS
  Two reviewers independently researched relevant studies using a standardized search strategy. The Institute of Medicine's quality framework (safe, effective, equitable, efficient, patient-centred, and accessible care) was applied in order to evaluate the performance of such facilities. In addition, the impact on the performance of full-service general hospitals was assessed.
  
  
  RESULTS
  Forty-six studies were included in the systematic review. Overall, the quality of the included studies was satisfactory. Our results show that little evidence exists to confirm the advantages attributed to physician-owned specialized facilities, and their impact on full-service general hospitals remains limited.
  
  
  CONCLUSIONS
  Although data is available on a wide variety of effects, the evidence base is surprisingly thin. There is no compelling evidence available demonstrating the added value of physician-owned specialized facilities in terms of quality or cost of the delivered care. More research is necessary on the relative merits of physician-owned specialized facilities. In addition, their corresponding impact on full-service general hospitals remains unclear. The development of physician-owned specialized facilities should thus be monitored carefully.
authors.affiliation: Department of Public Health, Ghent University, De Pintelaan 185, B-9000 Gent, Belgium. Electronic address: jeroen.trybou@ugent.be.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Trybou
authors.affiliation: Department of Innovation, Entrepreneurship and Service Management, Ghent University, Tweekerkenstraat 2, B-9000 Gent, Belgium. Electronic address: melissa.deregge@ugent.be.
authors.forename: Melissa
authors.initials: M
authors.lastname: De Regge
authors.affiliation: Department of Innovation, Entrepreneurship and Service Management, Ghent University, Tweekerkenstraat 2, B-9000 Gent, Belgium. Electronic address: paul.gemmel@ugent.be.
authors.forename: Paul
authors.initials: P
authors.lastname: Gemmel
authors.affiliation: Faculty of Medicine and Health Science, Ghent University, De Pintelaan 185, B-9000 Gent, Belgium. Electronic address: philippe.duyck@aznikolaas.be.
authors.forename: Philippe
authors.initials: P
authors.lastname: Duyck
authors.affiliation: Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Elsene, Brussels, Belgium. Electronic address: lieven.annemans@ugent.be.
authors.forename: Lieven
authors.initials: L
authors.lastname: Annemans
mesh_terms: D006782:Hospitals, Special / Q000706:statistics & numerical data*; D006801:Humans; D010067:Ownership; D013531:Surgicenters / Q000706:statistics & numerical data*
keywords: Ambulatory surgery centre; Physician ownership; Specialty hospital; Systematic review