Reconfiguring emergency and acute services: time to pause and reflect

A dominant trend over the past few decades has been the reconfiguration of acute hospital services to provide more centralised and specialised care, particularly for complex conditions, resulting in fewer hospitals each serving a higher volume of patients. Centralisation is usually framed as a response to concerns about the safety of care in smaller hospitals. In this issue of the journal, Flojstrup and colleagues report on the impact of a hospital reconfiguration programme for emergency and acute care in Denmark.1 The ongoing programme, which began in 2008, involves closure of most small, rural hospitals and halving the number of acute hospitals. The quality of Danish registry data allows for the survival outcomes (adjusted in-hospital and 30-day mortality rates) of a large cohort (11 367 655 unplanned non-psychiatric episodes) to be described throughout the centralisation programme and across different diagnoses and arrival times. The use of a unique patient identifier...
Source: BMJ Quality and Safety - Category: General Medicine Authors: Tags: Editorials Source Type: research