Does better structure and process management provide higher outcome quality for the individual patient and among Danish hospital departments

Objective: The purpose is to explore whether better structure and process management provide better outcome quality for the individual patient and among hospital departments. Methods: Using patient level data in which 4,202 patients across seven vascular departments are pooled we estimate fixed effect logit models for three outcome quality measures; 30 day mortality, death after discharge and wound complications. First, we estimate the association between three process quality measures and the outcome quality for the individual patient. We then profile high- and lowperforming departments with respect to structural and process quality measures to explore whether more or less successful departments are characterised by specific features. Results: For the individual patient our results show that for death after discharge a higher length of stay reduces the risk of dying. At departmental level, our results suggest that staffing decisions may also be an important factor. However, additional research is needed in order to learn more about how structure and process indicators are associated with high-performance. Conclusions: Differences in outcome quality occur due to differences in the needs of patients treated, but also due to differences in how hospital departments organise care.