Co Melissa, Marks Tatjana, Tracey Freya, Conti Stefano, Clarke Geraldine M
Improvement Analytics Unit, The Health Foundation, London, England.
National Health Service (NHS) England, London, England.
Nat Commun. 2025 Jul 4;16(1):6192. doi: 10.1038/s41467-025-60936-6.
Elective surgical hubs at acute hospital trusts in England aim to increase productivity and efficiency in planned (elective) surgeries, reduce cancellations, and improve patient and staff experiences by ring-fencing care and focussing on High-Volume, Low Complexity (HVLC) surgeries. Using patient-level hospital data from April 2018 to December 2022, we evaluated the impact of new hubs (operational from 2019 onwards) and established hubs (operational before 2019) on trust-wide rates of total and HVLC elective surgeries using a generalised synthetic control methodology. Here, we show that during the first year of operation, the average rate of HVLC elective surgery in trusts with new hubs was 21.9% (95% CI 11.7%, 32.2%) higher than expected. After the COVID-19 pandemic, trusts with established hubs demonstrated greater resilience, with 11.2% higher than expected rates of total (1.3% to 21.2%) and HVLC (1.7% to 20.7%) elective surgery and 0.17 days (0.28 to 0.061) shorter than expected inpatient lengths of hospital stay. Our evaluation provides robust evidence to inform future priorities for elective care delivery.
英格兰急症医院信托机构的择期手术中心旨在通过划分护理范围并专注于高容量、低复杂性（HVLC）手术来提高计划性（择期）手术的生产率和效率，减少手术取消情况，并改善患者和工作人员的体验。利用2018年4月至2022年12月的患者层面医院数据，我们采用广义合成控制方法评估了新成立的中心（2019年起运营）和已有的中心（2019年前运营）对信托机构范围内全部和HVLC择期手术率的影响。在此，我们表明，在运营的第一年，拥有新中心的信托机构中HVLC择期手术的平均发生率比预期高21.9%（95%置信区间11.7%，32.2%）。在新冠疫情之后，拥有已有的中心的信托机构表现出更强的恢复力，全部（1.3%至21.2%）和HVLC（1.7%至20.7%）择期手术的发生率比预期高11.2%，住院时间比预期短0.17天（0.28至0.061天）。我们的评估提供了有力证据，可为未来择期护理服务的优先事项提供参考。
