Church-Owned Health Systems Best Secular, Study Says

Catholic and other church-owned health systems were more likely to provide higher quality performance to the communities they served than secular, not-for-profit health systems, according to a study from Thomson Reuters.

To assess the effects of ownership type on performance, Thomson Reuters analysts assigned 255 hospitals reviewed in its "100 Top Hospitals: Health System Benchmarks" study to one of four ownership categories: Catholic, other church, investor-owned, and not-for-profit. Those hospitals with missing ownership information were assigned to the "unknown" category.

Some of the healthcare systems were highly centralized—located in the same state or the same market area, while other systems had hospitals widely dispersed across multiple states or regions. In addition, the number of hospitals in each system could deviate widely.

To compensate for these differences, the researchers used the number of hospitals in each system as a variable to create a weighted average for the system performance. Using the rankings for system performance from the Health System study, a mean performance rank was calculated for each of the five ownership groups.

Overall, Catholic and other church-owned systems were listed first and second respectively in terms of being significantly more likely to provide higher quality performance and efficiencies to communities than investor-owned systems. Investor-owned systems demonstrated lower quality performance than all other groups.

"The findings of the study suggest a changing role for health system governance and leadership," says Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals programs at Thomson Reuters. "Our data suggest that the leadership of health systems owned by churches may be the most active in aligning quality goals and monitoring achievement of mission across the system."

The findings also imply a changing role for health system governance and leadership, according to the report. Many health systems were founded for economic purposes—such as access to capital, economies of scale, increased market share, and greater negotiating power with payers. Therefore, the responsibility for quality of care in most health systems could fall to local hospital governing boards.

This means that the leadership teams including boards, executives, and physician and nursing leaders of health systems owned by churches may be more active in aligning quality goals and watching achievement across the system, the report says.

Further study will be needed to better determine why these differences among systems exist and what impact they will have on the systems' future health—especially in light of changes expected with healthcare reform, it added. Researchers at the University of Michigan, School of Public Health currently are assessing this area.

The Health System Benchmarks study, which was released earlier this summer by Thomson Reuters, relied on public data from the 2007 and 2008 Medicare Provider Analysis and Review (MedPAR) data and the Centers for Medicare and Medicaid Services Hospital Compare data sets.