{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T09:08:50Z","timestamp":1779700130354,"version":"3.53.1"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Objective:<\/jats:title>\n To compare the influence of private equity acquisition on surgical quality among rural hospitals.<\/jats:p>\n <\/jats:sec>\n \n Summary and Background Data:<\/jats:title>\n Despite the growth of private equity\u2019s presence in healthcare markets and growing concerns of its adverse associations with quality of care, less is known about its influence on rural hospitals.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We evaluated common general surgery procedures (appendectomy, cholecystectomy, colectomy, and incisional hernia repair) among Medicare beneficiaries between 2011 and 2020. We defined rurality using Rural-Urban Commuting Area codes and identified rural hospitals acquired by private equity using the Private Equity Stakeholder Project Private Equity Hospital Tracker. We matched each private equity-acquired hospital with up to 10 similar rural hospitals not acquired by private equity. The primary outcome was 30-day postoperative mortality, and secondary outcomes included complications, serious complications, failure to rescue, and 30-day readmissions. We applied an event-time difference-in-differences framework with hospital and year fixed effects, controlling for beneficiary characteristics and comorbidities.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 96,048 patients across 390 rural hospitals, private equity acquisition was associated with statistically significant increases in 30-day mortality (1.1 percentage point increase,\n P<\/jats:italic>\n =0.04), complications (2.5 percentage point increase,\n P<\/jats:italic>\n =0.03), and serious complications (1.5 percentage point increase,\n P<\/jats:italic>\n =0.02) despite similar hospital characteristics and modest differences in patient demographics.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Private equity acquisition of rural hospitals was associated with some declines in surgical quality, which underscores the need to continue closely monitoring private equity\u2019s impact on rural healthcare delivery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/sla.0000000000007103","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:00:14Z","timestamp":1779681614000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Quality at Rural Hospitals After Private Equity Acquisition"],"prefix":"10.1097","author":[{"given":"Cody Lendon","family":"Mullens","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Michigan. Ann Arbor, MI"},{"name":"Center for Healthcare Outcomes and Policy, Institute for Health Policy and Innovation. Ann Arbor, MI"},{"name":"UM National Clinician Scholars Program. Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Mead","sequence":"additional","affiliation":[{"name":"Center for Healthcare Outcomes and Policy, Institute for Health Policy and Innovation. Ann Arbor, MI"},{"name":"University of Michigan Medical School. Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Abid","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of North Carolina. Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice C.","family":"Probst","sequence":"additional","affiliation":[{"name":"Arnold School of Public Health (Emerita), University of South Carolina, Columbia, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin B.","family":"Dimick","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan. Ann Arbor, MI"},{"name":"Center for Healthcare Outcomes and Policy, Institute for Health Policy and Innovation. Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan. Ann Arbor, MI"},{"name":"Center for Healthcare Outcomes and Policy, Institute for Health Policy and Innovation. Ann Arbor, MI"},{"name":"Taubman College of Architecture and Urban Planning, University of Michigan. Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Diaz","sequence":"additional","affiliation":[{"name":"Center for Healthcare Outcomes and Policy, Institute for Health Policy and Innovation. Ann Arbor, MI"},{"name":"Department of Surgery, University of Chicago. Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,25]]},"container-title":["Annals of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/SLA.0000000000007103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T09:00:10Z","timestamp":1779699610000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/SLA.0000000000007103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1097\/sla.0000000000007103","relation":{},"ISSN":["0003-4932","1528-1140"],"issn-type":[{"value":"0003-4932","type":"print"},{"value":"1528-1140","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]},"assertion":[{"value":"2025-12-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}