ArticleBMJ (Clinical research ed.)2011
Outcomes of elective surgery undertaken in independent sector treatment centres and NHS providers in England: audit of patient outcomes in surgery.
Article in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 89 citations in OpenAlex.
- Patient-reported outcomes in randomized controlled trials of spinal disorders: a methodological quality assessment and recommendations for future research.EFORT open reviews · 2026Pooled it
- A systematic review of the accessibility, acceptability, safety, efficiency, clinical effectiveness, and cost-effectiveness of private cataract and orthopedic surgery clinics.International journal of technology assessment in health care · 2023Pooled it
- Do patients scheduled for inguinal hernia repair express a preference for the repair technique? What questions do they frequently ask?Hernia : the journal of hernias and abdominal wall surgery · 2026Observational
- Determinants of quality in the independent and public hospital sectors in England.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025Article
- The effect of patients' socioeconomic status in rehabilitation centers on the efficiency and performance.European journal of physical and rehabilitation medicine · 2024Article
- Time trends in case-mix and risk of revision following hip and knee arthroplasty in public and private hospitals: a cross-sectional analysis based on 476,312 procedures from the Dutch Arthroplasty Register.Acta orthopaedica · 2024Article
- 'Two sides of the same coin'? A longitudinal analysis evaluating whether financial austerity accelerated NHS privatisation in England 2013-2020.BMJ public health · 2024Article
- Patient outcomes, efficiency, and adverse events for elective hip and knee replacement in private and NHS hospitals: a population-based cohort study in England.The Lancet regional health. Europe · 2024Article
- From opera buffa to opera seria: anniversaries of Royal College of Surgeons of England research initiatives.The British journal of surgery · 2024Article
- Patient preferences and choices as a reflection of trust-A cluster analysis comparing postsurgical perceptions in a private and a public hospital.Health expectations : an international journal of public participation in health care and health policy · 2022Article
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- Outcomes for surgical procedures funded by the English health service but carried out in public versus independent hospitals: a database study.BMJ quality & safety · 2022Article
- Outsourcing health-care services to the private sector and treatable mortality rates in England, 2013-20: an observational study of NHS privatisation.The Lancet. Public health · 2022Observational
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- Divided by choice? For-profit providers, patient choice and mechanisms of patient sorting in the English National Health Service.Health economics · 2021Article
- Patient-Reported Outcomes Following Lumbar Decompression Surgery: A Review of 2699 Cases.Global spine journal · 2021Article
- Assessment of a patient-reported outcome measure in men with prostate cancer who had radical surgery: a Rasch analysis.BMJ open · 2020Article
- Psychometric Evaluation of Patient-reported Outcomes Measurement Information System Physical Function Computer Adaptive Testing in Minimally Invasive Lumbar Spine Surgery: An Analysis of Responsiveness, Coverage, Discriminant Validity, and Concurrent Validity.The Journal of the American Academy of Orthopaedic Surgeons · 2020Article
- Independent Treatment Centres Are Not a Guarantee for High Quality and Low Healthcare Prices in The Netherlands - A Study of 5 Elective Surgeries.International journal of health policy and management · 2020Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo compare characteristics of patients and outcomes after elective surgery in independent sector treatment centres (ISTCs) and NHS providers.
designFollow-up study with outcomes reported by patients three to six months after surgery.
setting25 ISTCs and 72 NHS providers in England. Population Consecutive patients undergoing hip or knee replacement (5671 in ISTCs and 14,292 in NHS), inguinal hernia repair (640 and 2023, respectively), or surgery for varicose veins (248 and 1336, respectively). MAIN OUTCOMES: Symptoms and disability reported by patients (Oxford hip and knee scores on a 48 point scale; Aberdeen varicose vein questionnaire) and quality of life (EuroQol EQ-5D score).
resultsPatients in ISTCs were healthier than those in NHS providers, had less severe preoperative symptoms, and were more affluent, though the differences were small. With adjustment, patients undergoing joint replacements in NHS providers had poorer outcomes: difference of -1.7 (95% confidence interval -2.5 to -0.9) on the Oxford hip score and -0.9 (-1.6 to -0.2) on the Oxford knee score. They more often reported complications: odds ratio 1.3 (95% confidence interval 1.1 to 1.5) for hip and 1.4 (1.2 to 1.6) for knee. There were no significant differences in outcomes after surgery for hernia or varicose veins, except that NHS patients more often reported poor results after hernia repair (1.4, 1.0 to 1.9) and additional surgery after varicose vein surgery (2.8, 1.2 to 6.8).
conclusionPatients undergoing surgery in ISTCs were slightly healthier and had less severe conditions than those undergoing surgery in NHS providers. Some outcomes were better in ISTCs, but differences were small compared with the impact ISTCs could have on the provision of elective services.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.