Dominik Moser

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    Sex differences in patients hospitalized for repair of intact abdominal aortic aneurysms in 11 high-income countries: A cross-sectional cohort study
    (Elsevier BV, 2026-04)
    Woo, Seohyun
    ;
    Kim, Sun Jung
    ;
    Hwang, Soo-Hee
    ;
    Al-Azazi, Saeed
    ;
    Banerjee, Amitava
    Objective Sex differences in the treatment and outcomes of males and females undergoing intact abdominal aortic aneurysm (AAA) repair have been documented in single-country studies, with females tending to have worse outcomes. However, international comparisons of sex differences across countries using patient-level data and harmonized analytical methods are lacking. Methods We conducted a retrospective serial cross sectional cohort study using population-representative administrative data from 11 countries participating in the International Health Systems Research Collaborative (IHSRC) to identify adults aged 66+ years hospitalized for intact AAA repair between 2011 and 2019. We compared females and males within each country with respect to age- and comorbidity-adjusted AAA population-adjusted incidence of surgeries, 30-day and 1-year mortality, 30-day readmission, and hospital length of stay (LOS). Results Our intact AAA repair cohort sizes differed widely across our 11 countries, ranging from 200,151 in the United States (178,777 [78%] endovascular aneurysm repair [EVAR]; 21,374 [22%] open repair) to 1290 in Israel (1199 [89%] EVAR; 91[11%] open repair). Overall AAA population-adjusted incidence of surgeries (EVAR plus open repairs per 100,000 population per year) were significantly lower for females than males in all countries but the male to female repair ratio within countries differed widely. For example, in the United States there were approximately 4.5 male repairs per 1.0 female repair; in Israel the ratio was 10:1. Thirty-day and 1-year age- and comorbidity-adjusted mortality was higher for females than males in most countries (Switzerland, 1-year mortality: 8.5 female, 5.4 male). Females experienced longer hospital overall (EVAR plus open) LOS (eg, South Korea, male 17.9 days vs female 23.5 days) and higher rates of hospital readmission (eg, Israel, male 21.0% vs female 33.6%) than males. These disparities persisted across years and repair subtype. Conclusions Compared with males, females had lower AAA population-adjusted incidence of surgeries, higher mortality, higher readmission rates, and longer hospital LOS across 11 diverse high-income countries. However, the magnitude of the female-male differences were surprisingly variable. These findings raise important questions about whether these differences are manifestations of true clinical differences across countries or differences in how males and females are treated in each country. We suggest that countries with larger “gaps” explore the underlying drivers of these differences while simultaneously exploring opportunities to redesign care.
    Type:journal article
    Journal:Journal of Vascular Surgery
    Volume:online
    DOI:10.1016/j.jvs.2026.03.623
    URI:https://alexandria.unisg.ch/handle/20.500.14171/126855
    Scopus© Citations 2
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    Regionalization of Hip Fracture Care in Five High-Income Countries.
    (2025-06-24)
    Bakx, Pieter
    ;
    Godoy, Carlos
    ;
    Al-Azazi, Saeed
    ;
    Banerjee, Amitava
    ;
    Burrack, Nitzan
    To describe differences in regionalization of hip fracture care and the volume-outcome relationship in five countries. We conducted a population-based cross-sectional cohort study in Canada, Israel, the Netherlands, Taiwan, and the United States. Within each country, we stratified patients into quintiles based upon the volume of hip fractures in the hospital where they were treated. We measured regionalization by the proportion of acute-care hospitals that treated patients with hip fractures and summarized the hospital volume distribution by the ratio of hip fracture volumes for high-volume hospitals versus low-volume hospitals. We then examined age- and sex-standardized outcomes and treatment for patients treated at high-volume and low-volume hospitals. We used nationally representative administrative data on adults aged ≥ 66 years hospitalized with hip fracture from 2011 to 2019. We followed them until death or 365 days after the discharge date. Across countries, the percentage of all acute-care hospitals that treated hip fractures differed widely (from 37.0% in Canada to 82.8% in Israel), with high-volume hospitals treating 4-14 times as many hip fractures as low-volume hospitals. The absolute risk-adjusted difference in 30-day mortality for high-volume compared to low-volume hospitals ranged between (-1.9% [95% CI, -2.2 to -1.7] in Canada and +1.1% [95% CI, 0.4-1.8] in the Netherlands). The proportion of patients receiving non-operative fracture treatment was lower in high-volume hospitals than low-volume hospitals in all countries (-5.4% [95% CI, -6.5 to -4.3] in Israel to -0.1% [95% CI, -0.5 to 0.3] in the Netherlands). Hip fracture regionalization differed substantially across countries. The direction and the magnitude of association between greater regionalization and improved patient outcomes were inconsistent across countries.
    Type:journal article
    Journal:Health services research
    DOI:10.1111/1475-6773.70002
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/123111
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    Regionalization of Hip Fracture Care in Five High-Income Countries.
    (2025-06-24)
    Bakx, Pieter
    ;
    Godoy, Carlos
    ;
    Al-Azazi, Saeed
    ;
    Banerjee, Amitava
    ;
    Burrack, Nitzan
    Type:journal article
    Journal:Health services research
    DOI:10.1111/1475-6773.70002
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/124195
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    Qualitätsvariation in der Schweiz: Analyse der Mamma-Resektionen bei Brustkrebs anhand des Qualitätsindikators der Brusterhaltung
    (2023)
    Dominik Moser  
    ;
    Christine von Ahlen
    ;
    Alexander Geissler  
    Aim of study: The aim of the study was to investigate whether there are regional differences in the treatment results of elective mammary resections for breast cancer in Switzerland and, if so, whether a possible cause could be found in the hospital planning by the cantons. Methods: Using the Inpatient Quality Indicators (CH-IQI), the quality of outcomes was analysed at the level of the Swiss cantons and compared with the cantonal requirements for carrying out this treatment. Results: Cantonal differences became apparent both in the quality of results based on the quality indicator of breast preservation and in the level of detail of the requirements for structural and process quality. Conclusion: The quality of treatment in Switzerland can hardly be compared in a transparent manner; interpreting the available quality information is demanding and hardly possible for patients. In order to reduce the quality differences shown, hospital planning should be intercantonal, as is the case in highly specialised medicine.
    Type:journal article
    Journal:Senologie - Zeitschrift für Mammadiagnostik und -therapie
    Volume:20
    Issue:02
    DOI:10.1055/a-2081-4903
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/119080
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    Cost and Quality Comparison of Hernia Surgery in Stationary, Day-Patient and Outpatient Care
    (2022)
    Enodien, Bassey
    ;
    Moser, Dominik  
    ;
    Kessler, Florian
    ;
    Taha-Mehlitz, Stephanie
    ;
    Frey, Daniel M.
    Type:journal article
    Journal:International Journal of Environmental Research and Public Health
    Volume:19
    Issue:19
    DOI:10.3390/ijerph191912410
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/109270
    Scopus© Citations 4
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    Scopus© Citations 3
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    Qualitätsvariation in der Schweiz: Analyse der Mamma-Resektionen bei Brustkrebs anhand des Qualitätsindikators der Brusterhaltung
    (Georg Thieme Verlag KG, 2021-11-30)
    Moser, Dominik  
    ;
    von Ahlen, Christine
    ;
    Geissler, Alexander  
    Aim of study: The aim of the study was to investigate whether there are regional differences in the treatment results of elective mammary resections for breast cancer in Switzerland and, if so, whether a possible cause could be found in the hospital planning by the cantons. Methods; Using the Inpatient Quality Indicators (CH-IQI), the quality of outcomes was analysed at the level of the Swiss cantons and compared with the cantonal requirements for carrying out this treatment. Results: Cantonal differences became apparent both in the quality of results based on the quality indicator of breast preservation and in the level of detail of the requirements for structural and process quality. Conclusion: The quality of treatment in Switzerland can hardly be compared in a transparent manner; interpreting the available quality information is demanding and hardly possible for patients. In order to reduce the quality differences shown, hospital planning should be intercantonal, as is the case in highly specialised medicine.
    Type:journal article
    Journal:Das Gesundheitswesen
    Volume:11
    URL:https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1670-7249#info
    DOI:10.1055/a-1670-7249
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/109694
    Scopus© Citations 4
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    Qualitätstransparenz in der stationären Krankenhausversorgung der Schweiz
    (Georg Thieme Verlag KG, 2021-06-17)
    von Ahlen, Christine
    ;
    Moser, Dominik  
    ;
    Geissler, Alexander  
    Quality transparency is a crucial basis for reducing information asymmetries in the health care system. But what information on inpatient, acute-somatic care is available in Switzerland, how can it be used and what are the consequences? To answer these questions, a review of the data available is undertaken, systematically processed and strengths and weaknesses identified. On this basis, as well as international comparisons, health policy recommendations for an improvement of the current conditions follow. The study shows that quality transparency in Switzerland is limited, despite the national quality contract agreed in 2011. This makes it difficult to strengthen quality competition, to make informed decisions about patients’ choice of hospital and to contract selectively. Further development of the data and measurement instruments available in hospitals in Switzerland is therefore indicated and requires prioritised implementation.
    Type:journal article
    Journal:Gesundheitsökonomie und Qualitätsmanagement
    Volume:26
    Issue:03
    URL:https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1498-3528
    DOI:10.1055/a-1498-3528
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/110312
    Scopus© Citations 3
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