title: Trends in hospital ownership of physician practices and the effect on processes to improve quality.
abstract: OBJECTIVE
  Reports suggest a trend for physician practices to change ownership from physicians to hospitals. It remains unclear how this change affects quality of patient care. We report the effect of a change to hospital ownership on the use of care management processes (CMPs) and health information technology (IT) among practices in the United States.
  
  
  METHODS
  Trend analyses of 3 large national surveys of physician practices.
  
  
  METHODS
  We included 2 cohorts of practices: large practices with 20 or more physicians and small/medium practices with fewer than 20 physicians. The main outcomes were the changes in CMP and health IT indices among practices that were acquired by hospitals. We used multivariate logistic regression to assess these changes.
  
  
  RESULTS
  Large practices acquired by hospitals had larger increases in their CMP index than those that remained physician-owned (11.0-point increase vs 7.0-point decrease; adjusted P = .03). Small/medium practices acquired by hospitals had smaller but significantly higher increases in their CMP score (3.8 points vs 2.6 points; adjusted P = .04). Among all practices, there were no significant differences in the change of the health IT index.
  
  
  CONCLUSIONS
  We found a significant increase in the use of CMPs among practices that were acquired by hospitals and no difference in health IT use. These findings suggest that a trend for hospitals to own physician practices may have a positive effect on chronic disease management and quality of care.
authors.affiliation: Department of Public Health, Weill Cornell Medical College, 402 E. 67th St, Rm LA-218, New York, NY 10065. E-mail: tlfernan@med.cornell.edu.
authors.forename: Tara F
authors.initials: TF
authors.lastname: Bishop
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Shortell
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Ramsay
authors.forename: Kennon R
authors.initials: KR
authors.lastname: Copeland
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Casalino
mesh_terms: D004469:Economics, Hospital; D005260:Female; D006123:Group Practice / Q000191:economics; D019538:Health Care Surveys; D005102:Health Expenditures / Q000639:trends*; D006279:Health Maintenance Organizations / Q000191:economics* / Q000639:trends; D006801:Humans; D008297:Male; D010067:Ownership / Q000191:economics / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000639:trends; D011795:Surveys and Questionnaires; D014481:United States