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Impact of merging two university hospitals on surgical outcome after esophagogastric and hepato-pancreato-biliary surgery: Results from a retrospective study

Authors :
Ingwersen, E. W.
Stam, W. T.
van Kesteren, L. J.
Wissink, I. J. A.
van Berge Henegouwen, M. I.
Besselink, M. G.
Busch, O. R.
Erdmann, J. I.
Eshuis, W. J.
Gisbertz, S. S.
Kazemier, G.
van der Peet, D. L.
Swijnenburg, R. J.
Zonderhuis, B.
Daams, F.
Surgery
CCA - Cancer Treatment and quality of life
CCA - Cancer biology and immunology
AII - Cancer immunology
Amsterdam Gastroenterology Endocrinology Metabolism
AGEM - Re-generation and cancer of the digestive system
APH - Quality of Care
ACS - Microcirculation
Graduate School
Intensive Care Medicine
CCA - Cancer Treatment and Quality of Life
CCA - Imaging and biomarkers
AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
CCA -Cancer Center Amsterdam
Cancer Center Amsterdam
Source :
Surgery Open Science, 12, 1-8. Elsevier BV, Ingwersen, E W, Stam, W T, van Kesteren, L J, Wissink, I J A, van Berge Henegouwen, M I, Besselink, M G, Busch, O R, Erdmann, J I, Eshuis, W J, Gisbertz, S S, Kazemier, G, van der Peet, D L, Swijnenburg, R J, Zonderhuis, B & Daams, F 2023, ' Impact of merging two university hospitals on surgical outcome after esophagogastric and hepato-pancreato-biliary surgery : Results from a retrospective study ', Surgery Open Science, vol. 12, pp. 1-8 . https://doi.org/10.1016/j.sopen.2023.01.002, Surgery Open Science, 12, 1-8. Elsevier
Publication Year :
2023

Abstract

Background: Due to centralization and super-specialization in medicine, hospital mergers are increasingly common. Their effect on postoperative outcomes in highly specialized surgical departments is unclear. As quality metrics often worsen after major organizational changes, preservation of quality of care during an hospital merge is of the utmost importance. Objective: To evaluate the effect of a merger of two Dutch university hospitals on quality of surgical care, volume, and timeliness of care. Methods: The upper gastro-intestinal and hepato-biliary-pancreatic sections merged on the 27th of January 2020 and the 31th of May 2021 respectively. Outcomes of all adult surgical patients were compared six months before and six months after the merger. Short-term quality metrics, volume, and timeliness of care were assessed. Results: Overall, a cohort of 631 patients were included of whom 195 were upper gastro-intestinal (97 prior to the merger, 98 after the merger) and 436 (223 prior to the merger, 213 after) hepato-biliary-pancreatic patients. There were no differences in mortality, readmission, number and severity of complications, volume, and timeliness of care six months post-merger as compared to before merger. Conclusion: This study shows that a hospital merger of two university hospitals can be performed without jeopardizing patient safety and while benefitting from centralization of highly specialized care and enhancement of medical research. Key message: This study investigated the impact of a merger of two Dutch university hospitals on quality of care, timeliness of care, and volume. It showed no deterioration in the evaluated short-term quality metrics, volume or timeliness for upper GI and HPB surgery, suggesting that a hospital merger of two university hospitals can be performed safely, while benefitting from centralization of highly specialized care and enhancement of medical research.

Details

Language :
English
ISSN :
25898450
Database :
OpenAIRE
Journal :
Surgery Open Science, 12, 1-8. Elsevier BV, Ingwersen, E W, Stam, W T, van Kesteren, L J, Wissink, I J A, van Berge Henegouwen, M I, Besselink, M G, Busch, O R, Erdmann, J I, Eshuis, W J, Gisbertz, S S, Kazemier, G, van der Peet, D L, Swijnenburg, R J, Zonderhuis, B & Daams, F 2023, ' Impact of merging two university hospitals on surgical outcome after esophagogastric and hepato-pancreato-biliary surgery : Results from a retrospective study ', Surgery Open Science, vol. 12, pp. 1-8 . https://doi.org/10.1016/j.sopen.2023.01.002, Surgery Open Science, 12, 1-8. Elsevier
Accession number :
edsair.doi.dedup.....3f521575bcb8954352b0c44a5baafb5f
Full Text :
https://doi.org/10.1016/j.sopen.2023.01.002