The Influence of Physician–Hospital Integration on Physician Communication and Patient Experience: Evidence From U.S. Private Acute Care Hospitals

Background: Various forms of Physician–Hospital Integration (PHI) have occurred across the U.S. health care delivery system, and research has shown that the structure and characteristics of PHI models may influence various aspects of hospital performance. Purpose: This study explores the relationship between different PHI types and patient experience (PX), with a specific interest in the influence of these structures on physician communication and overall hospital ratings. Methodology: Using a Generalized Estimating Equations model, we analyzed data from 2,716 U.S. acute care hospitals (n=2,716) to explore how “tight,” “loose,” and “multimodal” PHI types influence PX during the COVID-19 pandemic, utilizing data from two time points: 2019 (prepandemic) and 2022 (post-peak pandemic). Results: Our results reveal that hospitals with “tight” PHI type, characterized by greater control over physicians, were associated with lower physician communication ratings and overall hospital ratings. Conclusions: Our findings suggest that rigid organizational structures may hinder effective physician-patient interactions and hospital performance during crises. Conversely, hospitals with “loose” PHI type demonstrated better resilience in maintaining PX, likely due to increased physician autonomy and flexibility in care delivery. Practice Implications: These findings highlight the importance of adaptable strategies in health care management, emphasizing the need for balance between physician oversight and autonomy to improve PX.