title: [Are emergency physicians influenced by nonmedical aspects in their choice of the hospital : Observations in 280 victims of out-of-hospital cardiac arrest in times of hospital alliances].
abstract: BACKGROUND
  Emergency physicians are responsible for the out-of-hospital treatment of victims from out-of-hospital cardiac arrest (OHCA), not only with regard on the medical treatment, but also in terms of the choice of the most suitable hospital. We therefore wanted to determine whether nonmedical processes such as hospital alliances lead to changing rates of hospital admissions of patients following OHCA.
  
  
  METHODS
  All patients who were admitted in our hospital following OHCA between 1 January 2008 and 30 June 2015 were identified and their data were anonymously stored in a central database. Afterward, we divided the study period into three periods: (1) the period prior to the publication of the ERC guidelines 2010, (2) the period after the publication of the ERC guidelines 2010, and (3) the period after a contract for hospital alliances with another hospital in town was signed.
  
  
  RESULTS
  Of the 280 OHCA victims, we could analyze the emergency physician's reports of 238 victims from nontraumatic OHCA; there were 143 men (60.1 %) and 95 women (39.9 %) with an age of 69.1 ± 13.7 years. Following the changes in the guidelines in 2010, we observed a 42.8 % increase of hospital admissions from 2.15 admissions per month to 3.07 in period 2 following OHCA compared to period 1. After signing of the hospital alliance, there was an additional increase of 42.3 % to an average of 4.37 hospital admissions per month.
  
  
  CONCLUSIONS
  According to our data, it might be possible that not only medical influences (e.g., changes in the guidelines) but also nonmedical aspects (e.g., hospital alliances) might influence the choice of hospital for the further treatment of victims from OHCA.
authors.affiliation: Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland. martin.christ@marienhospital-herne.de.
authors.forename: M
authors.initials: M
authors.lastname: Christ
authors.affiliation: Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
authors.forename: K I
authors.initials: KI
authors.lastname: von Auenmüller
authors.affiliation: Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Amirie
authors.affiliation: Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
authors.forename: B M
authors.initials: BM
authors.lastname: Sasko
authors.affiliation: Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Brand
authors.affiliation: Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Trappe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002755:Choice Behavior; D004632:Emergency Medical Services; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006273:Health Facility Merger; D006755:Hospital Shared Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D010343:Patient Admission; D010819:Physician's Role
keywords: Cardiopulmonary resuscitation; Emergency physician; Hospital alliances; Out-of-hospital cardiac arrest; Post-resuscitation care