{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:10:14Z","timestamp":1777932614559,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2007,8,1]],"date-time":"2007-08-01T00:00:00Z","timestamp":1185926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med Care Res Rev"],"published-print":{"date-parts":[[2007,8]]},"abstract":"<jats:p>Physician ownership of specialty hospitals has become commonplace in recent years in several states where certificate-of-need laws do not exist. The study examines trends in utilization rates for complex and simple spinal fusion procedures performed on injured workers with back\/spine disorders in two markets in Oklahoma. During the time period we examine, physician-owned spine or orthopedic specialty hospitals entered both market areas in Oklahoma. Because there were no market areas in Oklahoma without physician-owned spine or orthopedic hospitals to use as a comparison group, we also analyzed trends in utilization for these surgical procedures performed on Medicare beneficiaries. We compared utilization for these procedures in Oklahoma and three other states with a high concentration of physician-owned specialty hospitals (Kansas, South Dakota, and Arizona) to utilization rates for back surgery performed on Medicare patients who reside in the Northeast region. States in the Northeast constitute an appropriate control group because there are no physician-owned specialty hospitals in this region. Both analyses indicate that the entry of the physician-owned specialty hospitals was followed by substantial increases in the market area utilization rates for complex spinal fusion surgery. Conversely, such dramatic changes did not occur in the Northeast where physician-owned specialty hospitals do not exist. After considering but ruling out alternative explanations, the findings imply that the financial incentives linked to ownership coincided with significant changes in physicians' practice patterns.<\/jats:p>","DOI":"10.1177\/1077558707301953","type":"journal-article","created":{"date-parts":[[2007,8,7]],"date-time":"2007-08-07T12:13:11Z","timestamp":1186488791000},"page":"395-415","source":"Crossref","is-referenced-by-count":45,"title":["Utilization Changes Following Market Entry by Physician-owned Specialty Hospitals"],"prefix":"10.1177","volume":"64","author":[{"given":"Jean M.","family":"Mitchell","sequence":"first","affiliation":[{"name":"Georgetown University,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2007,8,1]]},"reference":[{"key":"atypb1","unstructured":"Abelson, R. 2003. Generous Medicare payments spur specialty hospital boom . New York Times, October 26, A1."},{"issue":"2","key":"atypb2","first-page":"1","volume":"6","author":"American Hospital Association.","year":"2004","journal-title":"Trendwatch"},{"key":"atypb3","first-page":"A1","author":"Armstrong, D.","year":"2005","journal-title":"Wall Street Journal"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.22.6.56"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa042325"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-7295.1988.tb01494.x"},{"key":"atypb7","volume-title":"Specialty hospitals: Geographic location, services provided, and financial performance","author":"General Accountability Office (GAO).","year":"2003"},{"key":"atypb8","volume-title":"Specialty hospital moratorium","author":"General Accountability Office (GAO).","year":"2005"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.25.1.106"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMhpr043631"},{"key":"atypb11","volume-title":"Study of physician-owned specialty hospitals required in Section 507 (c)(2) of the Medicare Prescription Drug, Improvement and Modernization Act of 2003","author":"Levitt, M.O.","year":"2005"},{"key":"atypb12","volume-title":"Report to Congress: Physician-owned specialty hospitals","author":"Medicare Payment Advisory Commission (MedPAC).","year":"2005"},{"key":"atypb13","volume-title":"Physician-owned specialty hospitals revisited","author":"Medicare Payment Advisory Commission (MedPAC).","year":"2006"},{"key":"atypb14","unstructured":"Mitchell, J.M. 1996. Physician joint ventures and self-referral: An empirical perspective. Pp. 299\u2014317 in Conflicts of interest in clinical practice and research, edited by R.G. Spece , D.S. Shimm, and A. Buchanan. New York: Oxford University Press."},{"key":"atypb15","first-page":"481","volume":"5","year":"2005","journal-title":"Health Affairs"},{"key":"atypb16","volume-title":"Testimony presented to the Subcommittee on Federal Financial Management, Government Information and International Security, U.S. Senate","author":"Pelosky, S."},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.25.1.119"},{"key":"atypb18","author":"Weintraub, A.","year":"2006","journal-title":"Business Week"}],"container-title":["Medical Care Research and Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1077558707301953","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1077558707301953","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:24:54Z","timestamp":1777685094000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1077558707301953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,8]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2007,8]]}},"alternative-id":["10.1177\/1077558707301953"],"URL":"https:\/\/doi.org\/10.1177\/1077558707301953","relation":{},"ISSN":["1077-5587","1552-6801"],"issn-type":[{"value":"1077-5587","type":"print"},{"value":"1552-6801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,8]]}}}