↓ Skip to main content

Is there a volume-quality relationship within the independent treatment centre sector? A longitudinal analysis

Overview of attention for article published in BMC Health Services Research, November 2019
Altmetric Badge

About this Attention Score

  • Average Attention Score compared to outputs of the same age

Mentioned by

twitter
1 tweeter

Citations

dimensions_citation
2 Dimensions

Readers on

mendeley
12 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Is there a volume-quality relationship within the independent treatment centre sector? A longitudinal analysis
Published in
BMC Health Services Research, November 2019
DOI 10.1186/s12913-019-4467-5
Pubmed ID
Authors

Florien Margareth Kruse, M. C. van Nieuw Amerongen, I. Borghans, A. S. Groenewoud, E. Adang, P. P. T. Jeurissen

Abstract

The number of independent treatment centres (ITCs) has grown substantially. However, little is known as to whether the volume-quality relationship exists within this sector and whether other possible organisational factors mediate this relationship. The aim of this study is to gain a better understanding of such possible relationships. Data originate from the Dutch Health and Youth Care Inspectorate (IGJ) and the Dutch Patients Association. We used longitudinal data from 4 years (2014-2017) including three different quality measures: 1) composite of structural and process indicators, 2) postoperative infections, and 3) patient satisfaction. We measured volume by the number of invasive treatments. We adjusted for three important organisational characteristics: (1) size of workforce, (2) chain membership, and (3) ownership status. For statistical inference, random effects analysis was used. We also ran several robustness checks for the volume-quality relationship, including a fractional logit model. ITCs with higher volumes scored better on structure, process and outcome (i.e. postoperative infections) indicators compared to the low-volume ITCs - although only marginally on outcome. However, ITCs with higher volumes do not have higher patient satisfaction. There is a decreasing marginal effect of volume - in other words, an L-shaped curve. The effect of the intermediating structural factors on the volume-quality relationship (i.e. workforce size, chain membership and ownership status) is less clear. Our findings suggest that chain membership has a negative influence on patient satisfaction. Furthermore, for-profit providers scored better on the Net Promoter Score. Our study shows with some certainty that the quality of care in low-volume ITCs is lower than in high-volume ITCs as measured by structural, process and outcome (i.e. postoperative infection) indicators. However, the size of the effect of volume on postoperative infections is small, and at higher volumes the marginal benefits (in terms of lower postoperative infections) decrease. In addition, volume is not related to patient satisfaction. Furthermore, the association between the structural intermediating factors and quality are tenuous.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 12 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 12 100%

Demographic breakdown

Readers by professional status Count As %
Professor 2 17%
Student > Ph. D. Student 2 17%
Other 1 8%
Student > Bachelor 1 8%
Researcher 1 8%
Other 0 0%
Unknown 5 42%
Readers by discipline Count As %
Medicine and Dentistry 4 33%
Economics, Econometrics and Finance 1 8%
Environmental Science 1 8%
Unknown 6 50%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 November 2019.
All research outputs
#10,397,244
of 16,287,035 outputs
Outputs from BMC Health Services Research
#4,123
of 5,632 outputs
Outputs of similar age
#227,821
of 386,524 outputs
Outputs of similar age from BMC Health Services Research
#481
of 664 outputs
Altmetric has tracked 16,287,035 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,632 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one is in the 17th percentile – i.e., 17% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 386,524 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 664 others from the same source and published within six weeks on either side of this one. This one is in the 19th percentile – i.e., 19% of its contemporaries scored the same or lower than it.