Management of groin hernia repair in Sweden : A register-based comparative analysis of public and private healthcare providers
(2024) In Scandinavian Journal of Surgery- Abstract
Background: Swedish healthcare is in a period of transition with an expanding private sector. This study compares quality of outcome after groin hernia repair performed in a public or private healthcare setting. Methods: A cohort study based on data from the Swedish National Hernia Register combined with Patient-Reported Outcome Measures (PROMs) 1 year after groin hernia repair. Between September 2012 and December 2018, a questionnaire was sent to all patients registered in the hernia register 1 year after surgery. Endpoints were reoperation for recurrence, chronic pain, and patient satisfaction. Results: From a total of 87,650 patients with unilateral groin hernia repair, 61,337 PROM answers (70%) were received from 71 public and 28... (More)
Background: Swedish healthcare is in a period of transition with an expanding private sector. This study compares quality of outcome after groin hernia repair performed in a public or private healthcare setting. Methods: A cohort study based on data from the Swedish National Hernia Register combined with Patient-Reported Outcome Measures (PROMs) 1 year after groin hernia repair. Between September 2012 and December 2018, a questionnaire was sent to all patients registered in the hernia register 1 year after surgery. Endpoints were reoperation for recurrence, chronic pain, and patient satisfaction. Results: From a total of 87,650 patients with unilateral groin hernia repair, 61,337 PROM answers (70%) were received from 71 public and 28 private healthcare providers. More females, acute and recurrent cases, and patients with high American Society of Anesthesiology (ASA) scores were operated under the national healthcare system. The private sector had more experience surgeons with higher annual volume per surgeon, shorter time on waiting lists, and shorter operation times. No difference was seen in patient satisfaction. Groin hernia repair performed in a private clinic was associated with less postoperative chronic pain (OR 0.85, 95% CI 0.8–0.91) but a higher recurrence rate (HR 1.41; 95% CI 1.26–1.59) in a multivariable logistic regression analysis. Conclusion: Despite private clinics having a higher proportion of experienced surgeons and fewer complex cases, the recurrence rate was higher, whereas the risk for chronic postoperative pain was higher among patients treated in the public sector.
(Less)
- author
- Hemberg, Anders LU ; Landén, Jakob ; Montgomery, Agneta LU ; Holmberg, Henrik and Nordin, Pär
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- in press
- subject
- keywords
- chronic pain, Groin hernia repair, patient satisfaction, public and private healthcare, reoperation for recurrence
- in
- Scandinavian Journal of Surgery
- publisher
- Finnish Surgical Society
- external identifiers
-
- pmid:38590013
- scopus:85190448909
- ISSN
- 1457-4969
- DOI
- 10.1177/14574969241242312
- language
- English
- LU publication?
- yes
- id
- f215dd02-412d-442b-80f1-2b810bb45c45
- date added to LUP
- 2024-04-29 10:59:06
- date last changed
- 2024-05-13 12:17:59
@article{f215dd02-412d-442b-80f1-2b810bb45c45,
abstract = {{<p>Background: Swedish healthcare is in a period of transition with an expanding private sector. This study compares quality of outcome after groin hernia repair performed in a public or private healthcare setting. Methods: A cohort study based on data from the Swedish National Hernia Register combined with Patient-Reported Outcome Measures (PROMs) 1 year after groin hernia repair. Between September 2012 and December 2018, a questionnaire was sent to all patients registered in the hernia register 1 year after surgery. Endpoints were reoperation for recurrence, chronic pain, and patient satisfaction. Results: From a total of 87,650 patients with unilateral groin hernia repair, 61,337 PROM answers (70%) were received from 71 public and 28 private healthcare providers. More females, acute and recurrent cases, and patients with high American Society of Anesthesiology (ASA) scores were operated under the national healthcare system. The private sector had more experience surgeons with higher annual volume per surgeon, shorter time on waiting lists, and shorter operation times. No difference was seen in patient satisfaction. Groin hernia repair performed in a private clinic was associated with less postoperative chronic pain (OR 0.85, 95% CI 0.8–0.91) but a higher recurrence rate (HR 1.41; 95% CI 1.26–1.59) in a multivariable logistic regression analysis. Conclusion: Despite private clinics having a higher proportion of experienced surgeons and fewer complex cases, the recurrence rate was higher, whereas the risk for chronic postoperative pain was higher among patients treated in the public sector.</p>}},
author = {{Hemberg, Anders and Landén, Jakob and Montgomery, Agneta and Holmberg, Henrik and Nordin, Pär}},
issn = {{1457-4969}},
keywords = {{chronic pain; Groin hernia repair; patient satisfaction; public and private healthcare; reoperation for recurrence}},
language = {{eng}},
publisher = {{Finnish Surgical Society}},
series = {{Scandinavian Journal of Surgery}},
title = {{Management of groin hernia repair in Sweden : A register-based comparative analysis of public and private healthcare providers}},
url = {{http://dx.doi.org/10.1177/14574969241242312}},
doi = {{10.1177/14574969241242312}},
year = {{2024}},
}