ArticleBMJ quality & safety2023
Mortality before and after reconfiguration of the Danish hospital-based emergency healthcare system: a nationwide interrupted time series analysis.
Article in BMJ quality & safety, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Emergency Department Closures and Patient Outcomes: Scoping Review of Impacts on Care, Equity, and System Performance.The western journal of emergency medicine · 2026Article
- Perceptions of workload in emergency care in the Netherlands and how to influence this: a qualitative study.BMC emergency medicine · 2025Article
- Reorganization of the Danish out-of-hours primary care - a descriptive study.Scandinavian journal of primary health care · 2025Article
- The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System.The International journal of health planning and management · 2025Review
- Restructuring the role of emergency departments in the healthcare systems: a vector to improving physician resilience.Internal and emergency medicine · 2025Review
- Characteristics and outcomes of emergency department patients across health care systems: an international multicenter cohort study.International journal of emergency medicine · 2024Article
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6 authors.
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Abstract
objectivesThe study aimed to investigate how the 'natural experiment' of reconfiguring the emergency healthcare system in Denmark affected in-hospital and 30-day mortality on a national level. The reconfiguration included the centralisation of hospitals and the establishment of emergency departments with specialists present around the clock.
designHospital-based cohort study.
settingAll public hospitals in Denmark.
participantsPatients with an unplanned contact from 1 January 2007 until 31 December 2016.
interventionsStepped-wedge reconfiguration of the Danish emergency healthcare system.
main outcome measuresWe determined the adjusted ORs for in-hospital mortality and HRs for 30-day mortality using logistic and Cox regression analysis adjusted for sex, age, Charlson Comorbidity Index, income, education, mandatory referral and the changes in the out of hours system in the Capital Region. The main outcomes were stratified by the time of arrival. We performed subgroup analyses on selected diagnoses: myocardial infarction, stroke, pneumonia, aortic aneurysm, bowel perforation, hip fracture and major trauma.
resultsWe included 11 367 655 unplanned hospital contacts. The adjusted OR for overall in-hospital mortality after reconfiguration of the emergency healthcare system was 0.998 (95% CI 0.968 to 1.010; p=0.285), and the adjusted OR for 30-day mortality was 1.004 (95% CI 1.000 to 1.008; p=0.045)). Subgroup analyses showed some possible benefits of the reconfiguration such as a reduction in-hospital and 30-day mortality for myocardial infarction, stroke, aortic aneurysm and major trauma.
conclusionsThe Danish emergency care reconfiguration programme was not associated with an improvement in overall in-hospital mortality trends and was associated with a slight slowing of prior improvements in 30-day mortality trends.
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