L. S. Tipsmark, B. Obel, T. Andersson, and R. Søgaard, “Emergency department reorganisation introducing increased autonomy: a mixed effects approach to evaluate the effects of a national policy,” Plos one, vol. 18, iss. 3 March, 2023.
Abstract
Background In 2007, a Danish national policy to future-proof emergency department (ED) performance was launched. The policy included several recommendations for the management and organisationOrganisationEn organisation er i forretningsudviklingssammenhænge en gruppe af mennesker, virksomheder, lande eller lignende som samles om at nå et fælles mål, som de har en fælles interesse i. Læs mere → of care that essentially introduced greater ED autonomy. In this study, we evaluate the effects of increased ED autonomy on readmission, mortality and episode costs for two large patient groups. Method A non-randomised stepped wedge study-design where all EDs gradually implemented the policy at different steps during the study period (2008–2016). The timing and extent of policy implementation was determined from a retrospective cross-sectional survey of all 21 Danish EDs. This was linked to all episodes of hip fracture (n = 79,697) and erysipelas (n = 39,900) identified in the Nation Patient Registry and with episode-level outcomes. Mixed effect models were specified for the outcomes of 30-day readmission, 30-day mortality and episode costs, and adjusted for relevant ED- and episode-level heterogeneity. Results Increased ED autonomy was associated with more readmissions (p
BibTeX
@article {orcid-0000000312835489-2023-10-1371-journal-pone-0283325,
title = {Emergency department reorganisation introducing increased autonomy: A mixed effects approach to evaluate the effects of a national policy},
year = {2023},
month = {3},
doi = {10.1371/journal.pone.0283325},
url = {https://pure.au.dk/portal/en/publications/88ea8151-a5f5-4db9-9041-57cbc88a9dde},
journal = {PLoS One},
updated = {2025-10-17T01:37:34+00:00},
publisher = {Public Library of Science},
volume = {18},
number = {3 March},
issn = {1932-6203},
language = {en},
abstract = {Background In 2007, a Danish national policy to future-proof emergency department (ED) performance was launched. The policy included several recommendations for the management and <span class="zeal-gloss" tabindex="0"><span class="zeal-gloss__term">organisation</span><span class="zeal-gloss__bubble" role="tooltip"><span class="zeal-gloss__title">Organisation</span><span class="zeal-gloss__body">En organisation er i forretningsudviklingssammenhænge en gruppe af mennesker, virksomheder, lande eller lignende som samles om at nå et fælles mål, som de har en fælles interesse i. </span><a class="zeal-gloss__more" href="https://zeal.dk/ordbog/organisation/">Læs mere →</a></span></span> of care that essentially introduced greater ED autonomy. In this study, we evaluate the effects of increased ED autonomy on readmission, mortality and episode costs for two large patient groups. Method A non-randomised stepped wedge study-design where all EDs gradually implemented the policy at different steps during the study period (2008–2016). The timing and extent of policy implementation was determined from a retrospective cross-sectional survey of all 21 Danish EDs. This was linked to all episodes of hip fracture (n = 79,697) and erysipelas (n = 39,900) identified in the Nation Patient Registry and with episode-level outcomes. Mixed effect models were specified for the outcomes of 30-day readmission, 30-day mortality and episode costs, and adjusted for relevant ED- and episode-level heterogeneity. Results Increased ED autonomy was associated with more readmissions (p