The Effects of Merger on Ratio of Elective versus Acute Specialized Somatic Care in Norway

Abstract

Background: Several studies on effects of hospital mergers have been performed, and some effects seem to be found, but few studies have been conducted on effects from hospital mergers in a Norwegian setting. To my knowledge no study has been conducted on effects from hospital mergers, regarding the ratio of acute or elective specialized care. More studies on effects of hospital mergers is needed to better understand the processes that takes place, during and after mergers occur, and especially in a Norwegian setting since few such studies have been conducted. Objective: To investigate whether effects from hospital mergers can be located regarding changes in acute or elective somatic care, that affect the ratio between them. The merger to be investigated is the merger of four former Norwegian hospitals that merged into Vestre Viken Hospital trust. This may be due to changes in production, registration practices or other practices. The four former hospitals which merged into Vestre Viken will also be studied individually to see whether potential changes are due to changes in any, or all of the hospitals. Further trends will be investigated. Method: Descriptive statistics are chosen as the main research tool in this thesis. Data on individual contacts or interactions which have received health care, are treated with removal of duplicates to extract unique values. Dummy variables are made so the statistical program is able to locate at which hospitals the health care has been delivered, and whether the care has been acute or not. Aggregated data are achieved through filtering of the production data of the hospital trust, which is accessed and performed in the hospitals IT systems. Trend-lines or regression lines are fitted as descriptive tools to show trends in provision of healthcare. Results: The ratio between acute and elective care changes a lot when comparing the two years before the merger and two years after. In the two years before the merger the ratio of acute care is about 65-69% when investigating the DRGs and number of department and hospital stays. In the two years after the merger, the same ratio is 70-77%. The trend-lines also indicate the same trend. But changes may not be due to merger, since the greatest change in ratio seems to occur in 2010, and not when merger takes place in the middle of 2009.