Working Paper: NBER ID: w28474
Authors: Atul Gupta; Sabrina T. Howell; Constantine Yannelis; Abhinav Gupta
Abstract: Amid an aging population and a growing role for private equity (PE) in elder care, this paper studies how PE ownership affects U.S. nursing homes using patient-level Medicare data. We show that PE ownership leads to lower-risk patients and increases mortality. After instrumenting for the patient-nursing home match, we recover a local average treatment effect on mortality of 11%. Declines in measures of patient well-being, nurse staffing, and compliance with care standards help to explain the mortality effect. Overall, we conclude that PE has nuanced effects, with adverse outcomes for a subset of patients.
Keywords: Private Equity; Nursing Homes; Mortality; Patient Outcomes; Healthcare Economics
JEL Codes: G3; G32; G34; G38; I1; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| nursing staff availability (J22) | mortality rates (I12) |
| PE ownership (H43) | mortality rates (I12) |
| PE ownership (H43) | nursing staff availability (J22) |
| PE ownership (H43) | patient composition (I11) |
| PE ownership (H43) | mobility (J62) |
| PE ownership (H43) | ulcer development (O12) |
| PE ownership (H43) | pain intensity (J28) |