{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T22:54:55Z","timestamp":1786488895611,"version":"build-2736575974"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"The Department of Anesthesiology and Intensive Care Medicine, Gentofte Hospital, Denmark","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"The National Hospital in the Faroe Islands","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"DOI":"10.13039\/501100003035","name":"Aase og Ejnar Danielsens Fond","doi-asserted-by":"publisher","award":["20-000044"],"award-info":[{"award-number":["20-000044"]}],"id":[{"id":"10.13039\/501100003035","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Graduate School of Health, Aarhus University, Denmark","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"The Department of Clinical Epidemiology, Aarhus University Hospital, Denmark","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The aim of accreditation is to improve quality of care and patient safety. However, studies on the effectiveness of accreditation on clinical outcomes are limited and inconsistent. Comparative studies have contrasted accredited with non-accredited hospitals or hospitals without a benchmark, but assessments of clinical outcomes of patients treated at hospitals undergoing accreditation are sparse. The Faroe Islands hospitals were accredited for the first time in 2017, making them an ideal place to study the impact of accreditation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to investigate the association between first-time hospital accreditation and length of stay (LOS), acute readmission (AR) and 30-day mortality in the unique situation of the Faroe Islands.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a before and after study based on medical record reviews in relation to first-time accreditation. All three Faroese hospitals were voluntarily accredited using a modified second version of the Danish Healthcare Quality Programme encompassing 76 standards. We included inpatients 18\u2009years or older treated at a Faroese hospital with one of six clinical conditions (stroke\/transient ischemic attack (TIA), bleeding gastic ulcer, chronic obstructive pulmonary disease (COPD), childbirth, heart failure and hip fracture) in 2012\u20132013 designated \u2018before accreditation\u2018or 2017\u20132018\u2018\u2009after accreditation\u2019. The main outcome measures were LOS, all-cause AR and all-cause 30-day mortality. We computed adjusted cause-specific hazard rate (HR) ratios using Cox Proportional Hazard regression with before accreditation as reference. The analyses were controlled for age, sex, cohabitant status, in-hospital rehabilitation, type of admission, diagnosis and cluster effect at patient and hospital levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean LOS was 13.4\u2009days [95% confidence interval (95% CI): 10.8, 15.9] before accreditation and 7.5\u2009days (95% CI: 6.10, 8.89) after accreditation. LOS of patients hospitalized after accreditation was significantly shorter [overall, adjusted HR\u2009=\u20091.23 (95% CI: 1.04, 1.46)]. By medical condition, only women in childbirth had a significantly shorter LOS [adjusted HR\u2009=\u20091.30 (95% CI: 1.04, 1.62)]. In total, 12.3% of inpatients before and 9.5% after accreditation were readmitted acutely within 30\u2009days of discharge, and 30-day mortality was 3.3% among inpatients before and 2.8% after accreditation, respectively. No associations were found overall or by medical condition for AR [overall, adjusted HR\u2009=\u20091.34 (95% CI: 0.82, 2.18)] or 30-day mortality [overall, adjusted HR\u2009=\u20091.33 (95% CI: 0.55, 3.21)]) after adjustment for potential confounding factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>First-time hospital accreditation in the Faroe Islands was associated with a significant reduction in LOS, especially of women in childbirth. Notably, shorter LOS was not followed by increased AR. There was no evidence that first-time accreditation lowered the risk of AR or 30-day mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/intqhc\/mzac015","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T12:12:08Z","timestamp":1647951128000},"source":"Crossref","is-referenced-by-count":4,"title":["Accreditation and clinical outcomes: shorter length of stay after first-time hospital accreditation in the Faroe Islands"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5708-7184","authenticated-orcid":false,"given":"Maria Daniella","family":"Bergholt","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Oluf Palmes All\u00e9 43-45, Aarhus N DK-8200, Denmark"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Copenhagen University Hospital, Gentofte Hospital, Gentofte Hospitalsvej 1, Hellerup DK-2900, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Von Plessen","sequence":"additional","affiliation":[{"name":"Policlinique M\u00e9dicale, Unisant\u00e9, Rue du Bugnon 44, Lausanne CH-1011, Switzerland"},{"name":"Institute for Clinical Research, University of Southern Denmark, Campusvej 55, Odense M DK-5230, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren paaske","family":"Johnsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University and Aalborg University Hospital, Frederik Bajers vej 5, Aalborg DK-9220, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7865-343X","authenticated-orcid":false,"given":"Peter","family":"Hibbert","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW 2109, Australia"},{"name":"IIMPACT in Health, Allied Health and Human Performance, School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0296-4957","authenticated-orcid":false,"given":"Jeffrey","family":"Braithwaite","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW 2109, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Brink","family":"Valentin","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University and Aalborg University Hospital, Frederik Bajers vej 5, Aalborg DK-9220, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Mette","family":"Falstie-Jensen","sequence":"additional","affiliation":[{"name":"Danish Clinical Registries (RKKP), Oluf Palmes All\u00e9 15, Aarhus N DK-8200, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"2022042213021725100_R1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1093\/intqhc\/mzn005","article-title":"Health sector accreditation research: a systematic review","volume":"20","author":"Greenfield","year":"2008","journal-title":"Int J Qual Health Care"},{"key":"2022042213021725100_R2","doi-asserted-by":"crossref","first-page":"2410","DOI":"10.1001\/jama.2018.18810","article-title":"Accreditation, quality, and making hospital care better","volume":"320","author":"Jha","year":"2018","journal-title":"JAMA"},{"key":"2022042213021725100_R3","first-page":"1117","article-title":"Accrediting 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A Danish nationwide population-based study","volume":"27","author":"Falstie-Jensen","year":"2015","journal-title":"Int J Qual Health Care"},{"key":"2022042213021725100_R13","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/SLA.0000000000000891","article-title":"Does hospital accreditation impact bariatric surgery safety?","volume":"260","author":"Morton","year":"2014","journal-title":"Ann Surg"},{"key":"2022042213021725100_R14","doi-asserted-by":"crossref","DOI":"10.1186\/s13033-016-0090-6","article-title":"Effect of accreditation on length of stay in psychiatric inpatients: pre-post accreditation medical record comparison","volume":"10","author":"Al-Sughayir","year":"2016","journal-title":"Int J Ment Health Syst"},{"key":"2022042213021725100_R15","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1093\/intqhc\/mzy037","article-title":"Consecutive cycles of hospital accreditation: persistent low compliance associated with higher mortality and longer length of stay","volume":"30","author":"Falstie-Jensen","year":"2018","journal-title":"Int J Qual Health Care"},{"key":"2022042213021725100_R16","article-title":"Comparison of major clinical outcomes between accredited and nonaccredited hospitals for inpatient care of acute myocardial infarction","volume":"18","author":"Lee","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2022042213021725100_R17","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1093\/intqhc\/mzv023","article-title":"Compliance with hospital accreditation and patient mortality: a Danish nationwide population-based study","volume":"27","author":"Falstie-Jensen","year":"2015","journal-title":"Int J Qual Health Care"},{"key":"2022042213021725100_R18","article-title":"Association between accreditation and in-hospital mortality in patients with major cardiovascular diseases in South Korean hospitals: pre-post accreditation comparison","volume":"56","author":"Chun","year":"2020","journal-title":"Medicina (Kaunas)"},{"key":"2022042213021725100_R19","first-page":"416","article-title":"Effects of national hospital accreditation in acute coronary syndrome on in-hospital mortality and clinical outcomes","volume":"36","author":"Ko","year":"2020","journal-title":"Acta Cardiol Sin"},{"key":"2022042213021725100_R20","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.013384","article-title":"Chest pain center accreditation is associated with improved in-hospital outcomes of acute myocardial infarction patients in China: findings from the CCC-ACS project","volume":"8","author":"Fan","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2022042213021725100_R21","doi-asserted-by":"crossref","first-page":"908","DOI":"10.3324\/haematol.2013.096461","article-title":"Use of the quality management system \u201cJACIE\u201d and outcome after hematopoietic stem cell transplantation","volume":"99","author":"Gratwohl","year":"2014","journal-title":"Haematologica"},{"key":"2022042213021725100_R22","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.annemergmed.2009.01.025","article-title":"An analysis of the Association of Society of Chest Pain Centers Accreditation to American College of Cardiology\/American Heart Association non-ST-segment elevation myocardial infarction guideline adherence","volume":"54","author":"Chandra","year":"2009","journal-title":"Ann Emerg Med"},{"key":"2022042213021725100_R23","doi-asserted-by":"crossref","DOI":"10.3802\/jgo.2018.29.e23","article-title":"Impact of institutional accreditation by the Japan Society of Gynecologic Oncology on the treatment and survival of women with cervical cancer","volume":"29","author":"Mikami","year":"2018","journal-title":"J Gynecol Oncol"},{"key":"2022042213021725100_R24","article-title":"Toolkit for accreditation programs. 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