The Effect of Hospital Ownership on Health Care Utilization in Orthopedic Surgery

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To determine if ownership of a specialty hospital or ambulatory surgery centers (ASC) affects surgical volume.

Materials and Methods:

All surgeries performed by 75 orthopedic surgeons at a single practice between January 1, 2010 and March 1, 2015 were identified. During this time, the practice purchased an ownership stake in 1 hospital and 3 ASC. The total surgical volume by partnership status and location was collected and analyzed.


A total of 104,661 surgical surgeries were performed by 75 surgeons. Over the 62 months, there was an average increase in the number of surgical cases performed per surgeon per year of 2.82±0.48 cases; however, the average increase in cases per year was lower for equity partners by 1.51 cases per year (P<0.0001). In the 2 years before purchasing the specialty hospital, the increase in the number of surgical cases per surgeon per month was 0.093±0.087 cases. In the 2 years after investing in the physician-owned specialty hospital, there was a decrease in the number of cases performed per surgeon per month by 0.027±0.110 (P=0.92).


In a well-established large orthopedic practice, surgeon ownership of a hospital or ASC does not lead to an increase in surgical volume.

Level of Evidence:

Level 4.

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