title: Repair of recurrent hernia is often performed at a different clinic.
abstract: OBJECTIVE
  The aim of this study was to assess the extent of reoperations after hernia repair in Denmark that are being performed at a different facility than the primary repair and thereby investigate whether or not reoperation is a reliable basis for assessment of personal- or facility recurrence rates.
  
  
  METHODS
  On a national level, we included all groin hernia repairs that had been reoperated a least once from January 1, 1998, to August 19, 2015.
  
  
  RESULTS
  A total of 14,264 hernia repairs were included comprising a total of 7371 reoperations. We found that 26 % (n = 1883) of all reoperations were performed at a different healthcare facility. Time to reoperation, age at time of repair and having the primary repair performed at a private facility were all independent risk factors for being reoperated at a different facility in a logistic regression model.
  
  
  CONCLUSIONS
  One in four patients underwent repair for recurrent hernia at a different facility than the prior repair. Having the primary repair performed at a private hospital increased the risk of being reoperated at a different facility compared to having it performed at a public facility. This indicates that personal or institutional reoperation rates are underestimating the true reoperation rates, unless they can be followed in central registries or personal contact is made to all patients.
authors.affiliation: Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark. alexandernolsoe@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Nolsøe
authors.affiliation: Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Andresen
authors.affiliation: Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Rosenberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006119:Groin / Q000601:surgery; D006268:Health Facilities / Q000706:statistics & numerical data; D006550:Hernia, Femoral / Q000453:epidemiology / Q000601:surgery*; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000601:surgery*; D059685:Herniorrhaphy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult
keywords: Cohort; Database; Hernia; Recurrence; Reoperation