Observational studyBMJ open2025
Identifying high-impact-opportunity hospitals for improving healthcare quality based on a national population analysis of inter-hospital variation in mortality, readmissions and prolonged length of stay.
Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Healthier teams, safer care: workforce-driven determinants of quality of care and patient safety.European journal of public health · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo study between-hospital variation in mortality, readmissions and prolonged length of stay across Belgian hospitals.
designA retrospective nationwide observational study.
settingSecondary and tertiary acute-care hospitals in Belgium.
participantsWe studied 4 560 993 hospital stays in 99 (98%) Belgian acute-care hospitals between 2016 and 2018. PRIMARY OUTCOME MEASURES: Using generalised linear mixed models, we calculated hospital-specific and Major Diagnostic Category (MDC)-specific risk-adjusted in-hospital mortality, readmissions within 30 days and length of stay above the MDC-specific 90th percentile and assessed between-hospital variation through estimated variance components.
resultsThere was strong evidence of between-hospital variation in mortality, readmissions and prolonged length of stay across the vast majority of patient service lines. Overall, should hospitals with upper-quartile risk-standardised rates succeed in improving to the median level, a yearly 4076 hospital deaths, 3671 readmissions and 15 787 long patient stays could potentially be avoided in those hospitals. Our analysis revealed a select set of 'high-impact-opportunity hospitals' characterised by poor performance across outcomes and across a large number of MDCs.
conclusionsAnalysis of between-hospital variation highlights important differences in patient outcomes that are not explained by known patient or hospital characteristics. Identifying 'high-impact-opportunity hospitals' can help government inspection bodies and hospital managers to establish targeted audits and inspections to generate effective quality improvement initiatives.
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