ArticleMedical care2017
Can Vertical Integration Reduce Hospital Readmissions? A Difference-in-Differences Approach.
Article in Medical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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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
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Interventions to Promote Early Discharge and Avoid Inappropriate Hospital (Re)Admission: A Systematic Review.International journal of environmental research and public health · 2019Pooled it
- Vertical Integration in Healthcare Systems: A Systematic Review of the Literature.Portuguese journal of public health · 2026Review
- Use of quasi-experimental studies to evaluate causal effects of public health interventions in Portugal: a scoping review.BMC medical research methodology · 2025Article
- Association between physician age and patterns of end-of-life care among older Americans.Journal of the American Geriatrics Society · 2024Article
- Title: the impact of a pilot integrated care model on the quality and costs of inpatient care among chinese elderly: a difference-in-difference analysis of repeated cross-sectional data.Cost effectiveness and resource allocation : C/E · 2022Article
- Examination of care processes and treatment optimization for head and neck cancer patients in a community setting "hub and hub" model.World journal of otorhinolaryngology - head and neck surgery · 2022Review
- Does Vertical Integration Improve Access to Surgical Care for Medicaid Beneficiaries?Journal of the American College of Surgeons · 2020Article
- Patient experiences with outpatient care in Hungary: results of an online population survey.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Article
- Treatment Patterns in Veterans with Laryngeal and Oropharyngeal Cancer and Impact on Survival.Laryngoscope investigative otolaryngology · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVertical integration is expected to improve communication and coordination between inpatient care and care after discharge. Despite being used across health systems worldwide, evidence about its impact on readmissions is sparse and contradictory.
objectiveTo assess the impact of vertical integration on hospital readmissions. RESEARCH DESIGN, SUBJECTS, AND MEASURES: Using difference-in-differences we compared readmissions before and after vertical integration in 6 Portuguese hospitals for years 2004-2013. A control group with 6 similar hospitals not integrated was utilized. Considered outcome was 30-day unplanned readmission. We used logistic regression at the admission level and accounted for patients' risk factors using claims data. Analyses for each hospital and selected conditions were also run.
resultsOur results suggest that readmissions decreased overall after vertical integration [odds ratio (OR)=0.900; 95% confidence interval (CI), 0.812-0.997]. Hospital analysis indicated that there was no impact for 2 hospitals (OR=0.960; 95% CI, 0.848-1.087 and OR=0.944; 95% CI, 0.857-1.038), and a positive effect in 4 hospitals (greatest effect: OR=0.811; 95% CI, 0.736-0.894). A positive evolution was observed for a limited number of conditions, with better results for diabetes with complications (OR=0.689; 95% CI, 0.525-0.904), but no impact regarding congestive heart failure (OR=1.067; 95% CI, 0.827-1.377).
conclusionsMerging acute and primary care providers was associated with reduced readmissions, even though improvements were not found for all institutions or condition-specific groups. There are still challenges to be addressed regarding the success of vertical integration in reducing 30-day hospital readmissions.
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