title: Mortality outcomes in hospitals with public, private not-for-profit and private for-profit ownership in Chile 2001-2010.
abstract: Public, private not-for-profit (PNFP) and private for-profit (PFP) hospitals may have different behaviour and performance in different indicators such as health outcomes, cost-efficiency and quality. Chile has a mixed healthcare system both in financing and service delivery. The public National Health Fund (Fondo Nacional de Salud) covers 76% of the population-poorer and with higher health risks-whereas private health insurers cover 16% of the population-richer and with lower health risks. The aim of the study was to analyse the in-patient mortality outcomes by hospital ownership in Chile.
  
  
  METHODS
  We use hospital discharge data in Chile for the period 2001-10 with a total of 16,205,314 discharges in 20 public, 6 PNFP and 15 PFP hospitals. We analyse in-patient mortality considering all diagnoses and a subsample considering only myocardial infarction and stroke diagnoses. Using a probit regression, we estimate how hospital ownership explains in-patient mortality controlling for other confounding variables like health and socioeconomic status, and hospital characteristics.
  
  
  RESULTS
  The discharge condition was reported as death in 3.5% of the public hospitals' discharges, 1.3% in PNFP and 0.7% in PFP. PNFP and PFP hospitals show a lower risk of in-hospital mortality for all diagnoses, myocardial infarction and stroke in comparison with public hospitals.
  
  
  CONCLUSIONS
  The question about which type of hospital ownership performs better in Chile remains open. Policy decisions regarding health service provision requires more evidence explaining differences by ownership. Better controls for health risk and hospital characteristics are suggested to address these differences in hospital performance.
authors.affiliation: Department of Public Health, Faculty of Medicine, P. Universidad Católica de Chile, Marcoleta 434 Santiago Casilla 114D, Chile and Av. Salaverry 2020, Jesús María, Lima 11, Perú
authors.forename: Camilo
authors.initials: C
authors.lastname: Cid Pedraza
authors.affiliation: Department of Public Health, Faculty of Medicine, P. Universidad Católica de Chile, Marcoleta 434 Santiago Casilla 114D, Chile and Av. Salaverry 2020, Jesús María, Lima 11, Perú cristianhr@gmail.com.
authors.forename: Cristian A
authors.initials: CA
authors.lastname: Herrera
authors.affiliation: Department of Public Health, Faculty of Medicine, P. Universidad Católica de Chile, Marcoleta 434 Santiago Casilla 114D, Chile and Av. Salaverry 2020, Jesús María, Lima 11, Perú
authors.forename: Lorena
authors.initials: L
authors.lastname: Prieto Toledo
authors.affiliation: Department of Public Health, Faculty of Medicine, P. Universidad Católica de Chile, Marcoleta 434 Santiago Casilla 114D, Chile and Av. Salaverry 2020, Jesús María, Lima 11, Perú
authors.forename: Felipe
authors.initials: F
authors.lastname: Oyarzún
mesh_terms: D000328:Adult; D002677:Chile; D005260:Female; D017052:Hospital Mortality; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D010067:Ownership / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D020521:Stroke / Q000401:mortality
keywords: Chile; hospitals; mortality; public/private