Relative performance of for-profit psychiatric hospitals in investor-owned systems and nonprofit psychiatric hospitals

Am J Psychiatry. 1993 Jan;150(1):77-82. doi: 10.1176/ajp.150.1.77.


Objective: The authors analyzed the differences in operational and financial performance between 42 matched pairs of for-profit psychiatric hospitals belonging to multifacility organizations and nonprofit psychiatric hospitals for the fiscal years ending in 1986 through 1990.

Method: The pairs of short-term hospitals were matched according to location, standard metropolitan statistical area, or wage index. Analyses were based on data on these hospitals from the Health Care Financing Administration. The groups of variables studied included the hospitals' operational performance and productivity, profitability and payer mix, revenue and expenses, and capital structure. Differences in the mean values of the variables for the for-profit hospitals and the nonprofit hospitals were analyzed by pairwise t tests.

Results: The for-profit organization hospitals had significantly higher net revenue, lower salary expenses, and higher profits than the nonprofit hospitals. Patients in the for-profit hospitals had longer stays, and these hospitals had fewer full-time employees per adjusted inpatient day and per adjusted discharge.

Conclusions: The higher prices and operating margins of the for-profit hospitals belonging to investor-owned systems reflect the profit-maximizing goal of these facilities. The ability of for-profit organization hospitals to achieve economies of scale in expenses, however, was not evident except in the case of salary expenses.

Publication types

  • Comparative Study

MeSH terms

  • Bed Occupancy
  • Capital Financing
  • Economics, Hospital
  • Efficiency
  • Financial Management, Hospital
  • Hospital Bed Capacity
  • Hospitals, Proprietary / economics*
  • Hospitals, Proprietary / organization & administration
  • Hospitals, Psychiatric / economics*
  • Hospitals, Psychiatric / organization & administration
  • Hospitals, Voluntary / economics*
  • Hospitals, Voluntary / organization & administration
  • Humans