Short summary

It is unknown how the reorganisation of the acute hospital service has influenced clinical routines and patient outcomes. The STREED project, which aims is to investigate the effects of the reorganisation of Danish hospital acute care on health care quality.

Rationale

Over the past decade, the Danish health care system has witnessed noticeable changes in the organisation of acute hospital services. The reorganisation involves investments for more than 6,3 billion EURO (over the past ten years) which have been used for new buildings, technology and equipment, in order to realise the objective of a modern and sustainable hospital sector. A centralisation of functions is deemed the primary prerequisite for improvements, leading to fewer but larger acute hospitals where specialised doctors are more readily available. The reorganisation resulted in a reduction from 44 to 21 hospitals providing emergency services.

The expectation to the Danish acute care, due to the reorganisation, is an overall high quality of care with optimised efficiency regarding resource use and costs. However, it is unknown how the reorganisation as a whole has influenced clinical routines and patient outcomes. This is the focus of the STREED project, which aims is to investigate the effects of the reorganisation of Danish hospital acute care on health care quality.

A framework for eight interrelated studies:

The framework of studies presented is based on cooperation between Centre for Quality, Region of Southern Denmark, University of Southern Denmark, Hospital of Southern Jutland, Odense University Hospital and Hospital of South West Jutland.

The research team included acute care physicians/researchers, an acute care professor, an associate professor, a senior researcher, a post-doc researcher, and a PhD fellow.

The structure of the STREED project closely relates to the Institute of Medicine's six perspectives on the quality of care. Hence, it aims to examine the effects of the abovementioned reorganisation on: safety, effectiveness, timeliness, efficiency, patient-centeredness and equity. Figure 1 presents the overarching research framework with eight interrelated studies.

Collaborating researchers and departments

Centre for Quality, Region of Southern Denmark

• Consultant and researcher Søren Bie Bogh, MHS, PhD
• Associate professor and Chief Physician Søren Birkeland, MD, cand.jur. PhD
• Head of Centre for QualityChristian von Plessen, MD, PhD

Southwest Jutland Hospital

• PhD fellow Marianne Fløjstrup, MD
• Clinical Associate ProfessorMikkel Brabrand, MD, PhD 

South Jutland hospital

• Clinical Associate Professor Christian Backer Mogensen, MD, PhD

Odense University Hospital

• Professor Annmarie Touborg Lassen, MD, PhD