In the current study, no volume effect was found between the hospital volume and effectiveness in terms of mortality, and there was only a weak tendency for positive association in terms of maintainability.
Probabilistic sensitivity analyses used triangular distributions of costs (dispersion obtained from the hospital records) and effectiveness.
In the current hip fracture case study, no clear relationship was found between hospital volume and effectiveness.
This is an issue of such impact on hospital productivity and effectiveness that it should not be up to the individual doctor (often in-training) to decide.
The hospital increased the effectiveness of the interventions by adapting them to contextual changes, as indicated by Fixsen et al. [ 30].
Moreover, the hospital increased the effectiveness of changes by fitting them to a constantly changing context in a way pointed out by Fixsen et al. [ 45].
Main outcome measures Decrease in rotavirus gastroenteritis episodes (non-severe and severe), deaths, outpatient visits, and admission to hospital; incremental cost effectiveness ratio of vaccination expressed as net cost in 2007 rupees per life year saved.
In the USA, Padula et al. [ 38] modeled a guideline-based PU prevention strategy versus standard of care for 1 year for patients admitted to an acute care hospital with cost effectiveness extrapolation to the remaining lifespan of patients.
Secondary endpoints included health related quality of life, length of hospital stay, cost effectiveness, and the clinical efficacy of the device in relation to the degree of contamination, patient comorbidities, and operative demographics.
In a recent three-year study exploring how the organisational and cultural structure of hospitals affects clinical effectiveness, patient safety and patient experience in EU countries, eight key challenges for improvement were identified.
