Our Summary

This research paper investigates whether the quality of care for complex surgeries, such as esophagectomy (removal of part or all of the esophagus), differs between hospitals bought by private equity firms and those that are not.

The study looked at elderly patients who had this surgery between 2016 and 2020, and compared results from hospitals bought by private equity firms with those that were not. The main things the researchers looked at were complications, deaths, failed attempts to save a patient’s life, and readmissions within 30 days after the surgery.

They found that fewer of these surgeries were performed annually at hospitals owned by private equity firms compared to those that were not. More importantly, they found that patients at the private equity-owned hospitals had significantly higher rates of complications, deaths, serious complications, and failed attempts to save a patient’s life within 30 days after surgery.

Based on these findings, the researchers suggest that patients who have this surgery at hospitals owned by private equity firms may fare worse than those at other hospitals. They recommend further investigation to understand why these differences exist and to guide policy decisions about where patients should be treated for these types of conditions.

FAQs

  1. Does the quality of care for esophagectomy differ between hospitals owned by private equity firms and those that are not?
  2. What were the main findings of the study regarding the quality of care at private equity-owned hospitals versus non-private equity-owned hospitals?
  3. Based on the study, what are the researchers’ recommendations for patients who need an esophagectomy and for healthcare policy decisions?

Doctor’s Tip

A doctor might advise a patient undergoing an esophagectomy to carefully consider the hospital where they choose to have the surgery. They may suggest researching the hospital’s ownership and looking into the hospital’s track record with this particular procedure. It is important to prioritize quality of care and outcomes when making this decision.

Suitable For

Patients who are typically recommended esophagectomy include those with esophageal cancer, Barrett’s esophagus with high-grade dysplasia, severe gastroesophageal reflux disease (GERD) unresponsive to other treatments, esophageal strictures, esophageal diverticula, or esophageal motility disorders. Additionally, patients with large or high-risk esophageal tumors may also be recommended for esophagectomy. These patients may have tried other treatments and have not had success, or their condition may be at a stage where surgery is the best option for treatment.

Timeline

Before esophagectomy:

  1. Patient is diagnosed with a condition that requires removal of part or all of the esophagus.
  2. Patient undergoes pre-operative tests, consultations, and preparation for surgery.
  3. Surgery is scheduled and patient is admitted to the hospital.
  4. Esophagectomy is performed, which involves removing part or all of the esophagus and reconstructing it.
  5. Patient recovers in the hospital for a few days to weeks, depending on the extent of the surgery and any complications.

After esophagectomy:

  1. Patient may experience pain, difficulty swallowing, and changes in diet and eating habits.
  2. Patient undergoes post-operative care, including monitoring for complications such as infection, leakage, or strictures.
  3. Patient may require additional treatments such as chemotherapy or radiation therapy, depending on the underlying condition.
  4. Patient is discharged from the hospital and continues to recover at home.
  5. Patient undergoes follow-up appointments and tests to monitor their progress and address any ongoing issues or complications.

Overall, the recovery process after esophagectomy can be lengthy and challenging, and requires close monitoring and follow-up care to ensure the best possible outcomes for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about esophagectomy include:

  1. How many esophagectomy procedures do you perform annually at this hospital?
  2. What is the success rate of esophagectomy procedures at this hospital?
  3. What are the potential complications and risks associated with esophagectomy?
  4. How long is the recovery process expected to take?
  5. What is the hospital’s protocol for managing post-operative pain and discomfort?
  6. What are the criteria for determining if a patient is a good candidate for esophagectomy?
  7. What is the hospital’s track record for post-operative complications, deaths, and readmissions within 30 days after surgery?
  8. Are there any alternative treatment options to consider before proceeding with esophagectomy?
  9. What is the multidisciplinary team involved in my care and what role does each member play?
  10. Are there any specific guidelines or recommendations for post-operative care and follow-up appointments?

It is important for patients to have open and honest communication with their healthcare providers to ensure they are well-informed and comfortable with their treatment plan.

Reference

Authors: Williams JE, Schaefer SL, Jacobs RC, Ibrahim AM, Odell DD. Journal: JAMA Surg. 2025 Mar 1;160(3):296-302. doi: 10.1001/jamasurg.2024.5920. PMID: 39745696