Impact of hospital mergers: a systematic review focusing on healthcare quality measures.

Autor:	Mariani M; Sezione di Igiene, Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia., Sisti LG; Istituto Nazionale per la promozione della salute delle popolazioni migranti ed il contrasto delle malattie della Povertà (INMP), Roma, Italia.; Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia., Isonne C; Sapienza Università di Roma, Roma, Italia., Nardi A; Sapienza Università di Roma, Roma, Italia., Mete R; Sapienza Università di Roma, Roma, Italia., Ricciardi W; Sezione di Igiene, Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia., Villari P; Sapienza Università di Roma, Roma, Italia., De Vito C; Sapienza Università di Roma, Roma, Italia., Damiani G; Sezione di Igiene, Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.
Jazyk:	angličtina
Zdroj:	European journal of public health [Eur J Public Health] 2022 Apr 01; Vol. 32 (2), pp. 191-199.
DOI:	10.1093/eurpub/ckac002
Abstrakt:	Background: Despite mergers have increasingly affected hospitals in the recent decades, literature on the impact of hospitals mergers on healthcare quality measures (HQM) is still lacking. Our research aimed to systematically review evidence regarding the impact of hospital mergers on HQM focusing especially on process indicators and clinical outcomes. Methods: The search was carried out until January 2020 using the Population, Intervention, Comparison and Outcome model, querying electronic databases (MEDLINE, Scopus, Web Of Science) and refining the search with hand search. Studies that assessed HQM of hospitals that have undergone a merger were included. HQMs were analyzed through a narrative synthesis and a strength of the evidence analysis based on the quality of the studies and the consistency of the findings. Results: The 16 articles, included in the narrative synthesis, reported inconsistent findings and few statistically significant results. All indicators analyzed showed an insufficient strength of evidence to achieve conclusive results. However, a tendency in the decrease of the number of beds, hospital staff and inpatient admissions and an increase in both mortality and readmission rate for acute myocardial infarction and stroke emerged in our analysis. Conclusions: In our study, there is no strong evidence of improvement or worsening of HQM in hospital mergers. Since a limited amount of studies currently exists, additional studies are needed. In the meanwhile, hospital managers involved in mergers should adopt a clear evaluation framework with indicators that help to periodically and systematically assess HQM ascertaining that mergers ensure and primarily do not reduce the quality of care. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)
Databáze:	MEDLINE
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