Research activity and the association with mortality.
The aims of this study were to describe the key features of acute NHS Trusts with different levels of research activity and to investigate associations between research activity and clinical outcomes.National Institute for Health Research (NIHR) Comprehensive Clinical Research Network (CCRN) funding...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4342017?pdf=render |
| _version_ | 1828848196512645120 |
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| author | Baris A Ozdemir Alan Karthikesalingam Sidhartha Sinha Jan D Poloniecki Robert J Hinchliffe Matt M Thompson Jonathan D Gower Annette Boaz Peter J E Holt |
| author_facet | Baris A Ozdemir Alan Karthikesalingam Sidhartha Sinha Jan D Poloniecki Robert J Hinchliffe Matt M Thompson Jonathan D Gower Annette Boaz Peter J E Holt |
| author_sort | Baris A Ozdemir |
| collection | DOAJ |
| description | The aims of this study were to describe the key features of acute NHS Trusts with different levels of research activity and to investigate associations between research activity and clinical outcomes.National Institute for Health Research (NIHR) Comprehensive Clinical Research Network (CCRN) funding and number of patients recruited to NIHR Clinical Research Network (CRN) portfolio studies for each NHS Trusts were used as markers of research activity. Patient-level data for adult non-elective admissions were extracted from the English Hospital Episode Statistics (2005-10). Risk-adjusted mortality associations between Trust structures, research activity and, clinical outcomes were investigated.Low mortality Trusts received greater levels of funding and recruited more patients adjusted for size of Trust (n = 35, 2,349 £/bed [95% CI 1,855-2,843], 5.9 patients/bed [2.7-9.0]) than Trusts with expected (n = 63, 1,110 £/bed, [864-1,357] p<0.0001, 2.6 patients/bed [1.7-3.5] p<0.0169) or, high (n = 42, 930 £/bed [683-1,177] p = 0.0001, 1.8 patients/bed [1.4-2.1] p<0.0005) mortality rates. The most research active Trusts were those with more doctors, nurses, critical care beds, operating theatres and, made greater use of radiology. Multifactorial analysis demonstrated better survival in the top funding and patient recruitment tertiles (lowest vs. highest (odds ratio & 95% CI: funding 1.050 [1.033-1.068] p<0.0001, recruitment 1.069 [1.052-1.086] p<0.0001), middle vs. highest (funding 1.040 [1.024-1.055] p<0.0001, recruitment 1.085 [1.070-1.100] p<0.0001).Research active Trusts appear to have key differences in composition than less research active Trusts. Research active Trusts had lower risk-adjusted mortality for acute admissions, which persisted after adjustment for staffing and other structural factors. |
| first_indexed | 2024-12-12T22:25:10Z |
| format | Article |
| id | doaj.art-5fa737836dc6492281a0fbfbdb4cf1cd |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T22:25:10Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-5fa737836dc6492281a0fbfbdb4cf1cd2022-12-22T00:09:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01102e011825310.1371/journal.pone.0118253Research activity and the association with mortality.Baris A OzdemirAlan KarthikesalingamSidhartha SinhaJan D PolonieckiRobert J HinchliffeMatt M ThompsonJonathan D GowerAnnette BoazPeter J E HoltThe aims of this study were to describe the key features of acute NHS Trusts with different levels of research activity and to investigate associations between research activity and clinical outcomes.National Institute for Health Research (NIHR) Comprehensive Clinical Research Network (CCRN) funding and number of patients recruited to NIHR Clinical Research Network (CRN) portfolio studies for each NHS Trusts were used as markers of research activity. Patient-level data for adult non-elective admissions were extracted from the English Hospital Episode Statistics (2005-10). Risk-adjusted mortality associations between Trust structures, research activity and, clinical outcomes were investigated.Low mortality Trusts received greater levels of funding and recruited more patients adjusted for size of Trust (n = 35, 2,349 £/bed [95% CI 1,855-2,843], 5.9 patients/bed [2.7-9.0]) than Trusts with expected (n = 63, 1,110 £/bed, [864-1,357] p<0.0001, 2.6 patients/bed [1.7-3.5] p<0.0169) or, high (n = 42, 930 £/bed [683-1,177] p = 0.0001, 1.8 patients/bed [1.4-2.1] p<0.0005) mortality rates. The most research active Trusts were those with more doctors, nurses, critical care beds, operating theatres and, made greater use of radiology. Multifactorial analysis demonstrated better survival in the top funding and patient recruitment tertiles (lowest vs. highest (odds ratio & 95% CI: funding 1.050 [1.033-1.068] p<0.0001, recruitment 1.069 [1.052-1.086] p<0.0001), middle vs. highest (funding 1.040 [1.024-1.055] p<0.0001, recruitment 1.085 [1.070-1.100] p<0.0001).Research active Trusts appear to have key differences in composition than less research active Trusts. Research active Trusts had lower risk-adjusted mortality for acute admissions, which persisted after adjustment for staffing and other structural factors.http://europepmc.org/articles/PMC4342017?pdf=render |
| spellingShingle | Baris A Ozdemir Alan Karthikesalingam Sidhartha Sinha Jan D Poloniecki Robert J Hinchliffe Matt M Thompson Jonathan D Gower Annette Boaz Peter J E Holt Research activity and the association with mortality. PLoS ONE |
| title | Research activity and the association with mortality. |
| title_full | Research activity and the association with mortality. |
| title_fullStr | Research activity and the association with mortality. |
| title_full_unstemmed | Research activity and the association with mortality. |
| title_short | Research activity and the association with mortality. |
| title_sort | research activity and the association with mortality |
| url | http://europepmc.org/articles/PMC4342017?pdf=render |
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