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. 2020 Aug;77(4):357-366.
doi: 10.1177/1077558718823130. Epub 2019 Jan 23.

Landscape of Health Systems in the United States

Michael F Furukawa  1 , Rachel M Machta  2 , Kirsten A Barrett  3 , David J Jones  4 , Stephen M Shortell  5 , Dennis P Scanlon  6 , Valerie A Lewis  7 , A James O'Malley  7 , Ellen R Meara  7 , Eugene C Rich  3
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Landscape of Health Systems in the United States

Michael F Furukawa et al. Med Care Res Rev. 2020 Aug.

Abstract

Despite the prevalence of vertical integration, data and research focused on identifying and describing health systems are sparse. Until recently, we lacked an enumeration of health systems and an understanding of how systems vary by key structural attributes. To fill this gap, the Agency for Healthcare Research and Quality developed the Compendium of U.S. Health Systems, a data resource to support research on comparative health system performance. In this article, we describe the methods used to create the Compendium and present a picture of vertical integration in the United States. We identified 626 health systems in 2016, which accounted for 70% of nonfederal general acute care hospitals. These systems varied by key structural attributes, including size, ownership, and geographic presence. The Compendium can be used to study the characteristics of the U.S. health care system and address policy issues related to provider organizations.

Keywords: delivery system organization; health systems; hospital–physician affiliations; vertical integration.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart describing the construction of the Agency for Healthcare Research and Quality’s (AHRQ) Compendium of U.S. Health Systems, 2016.
Figure 2.
Figure 2.
Percentage of hospital beds belonging to health systems, by state. Note. Data come from the 2016 AHRQ Compendium of U.S. Health Systems.
See this image and copyright information in PMC

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