TY - JOUR
T1 - Impact of merging two university hospitals on surgical outcome after esophagogastric and hepato-pancreato-biliary surgery
T2 - Results from a retrospective study
AU - Ingwersen, E. W.
AU - Stam, W. T.
AU - van Kesteren, L. J.
AU - Wissink, I. J. A.
AU - van Berge Henegouwen, M. I.
AU - Besselink, M. G.
AU - Busch, O. R.
AU - Erdmann, J. I.
AU - Eshuis, W. J.
AU - Gisbertz, S. S.
AU - Kazemier, G.
AU - van der Peet, D. L.
AU - Swijnenburg, R. J.
AU - Zonderhuis, B.
AU - Daams, F.
N1 - Publisher Copyright: © 2023
PY - 2023/3/1
Y1 - 2023/3/1
N2 - 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.
AB - 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.
KW - Complications
KW - Hepato-biliary-pancreatic
KW - Merge
KW - Quality of care
KW - University centers
KW - Upper gastrointestinal
UR - http://www.scopus.com/inward/record.url?scp=85146839006&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.sopen.2023.01.002
DO - https://doi.org/10.1016/j.sopen.2023.01.002
M3 - Article
C2 - 36747974
SN - 2589-8450
VL - 12
SP - 1
EP - 8
JO - Surgery Open Science
JF - Surgery Open Science
ER -