ArticleThe Lancet regional health. Europe2026
Hospital acquisitions and 30-day mortality after acute myocardial infarction and stroke in Germany: a quasi-experimental cohort study.
Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Hospital consolidation has intensified globally, but evidence regarding its association with clinical quality remains mixed, particularly in universal healthcare systems with regulated prices. We assessed whether hospital acquisitions were associated with changes in 30-day excess mortality for acute myocardial infarction (AMI) and stroke. Methods: This quasi-experimental cohort study used a staggered difference-in-differences design analyzing German hospitals providing AMI or stroke care (2009-2019). We compared performance changes three years pre- and post-acquisition between acquired hospitals (n = 125 for AMI; n = 121 for stroke) and control hospitals with stable ownership (n = 821 for AMI; n = 830 for stroke). Primary outcomes were 30-day excess mortality rates. Secondary outcomes included medical staffing intensity and the provision of cardiac catheterization laboratories and stroke units. Findings: Acquisition was associated with a 1.24 percentage-point (pp) decline in excess 30-day AMI mortality within three years (95% CI -2.04 to -0.44; p = 0.002). This improvement coincided with a 6.63 pp increase in the probability of providing cardiac catheterization laboratories (0.75 to 12.52; p = 0.03). For stroke, the association with excess 30-day mortality indicated a clinically relevant but statistically insignificant 0.43 pp decline (-1.38 to 0.53; p = 0.44). Nurse staffing intensity transiently increased during the acquisition year for both AMI and stroke. Interpretation: In a regulated, fixed-price system, acquisitions were significantly associated with reduced AMI mortality and expanded interventional infrastructure. Findings suggest consolidation can improve clinical quality by unlocking capital for life-saving investments. While capital-intensive conditions like AMI benefit rapidly, complex care pathways like stroke likely require additional clinical integration strategies. Funding: German Research Foundation.
Indexed as
Identifiers
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.