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Independence in Hand and Plastic Surgery – Benefit or Barrier? Analysis of the Publication Performance in Academic Plastic Surgery Depending on Varying Organizational Structures
Riccardo E. Giunta, MD, PhD; Cornelius Schubert, MD, PhD
Handchirurgie, Plastische Chirurgie, Ästhetische Chirurgie, Klinikum der Ludwigs-Maximilians Universität München, München, Germany

Introduction: Despite its recognition as an independent specialty the field of plastic surgery remains underrepresented in terms of independent departments with a dedicated research-focus at German university hospitals. Similar is true for hand surgery. The aim of this study was to analyze the publication performance within the German academic plastic surgery environment and to compare independent departments and dependent, inferior organizational structures regarding its publication performance.

Material and Methods: Organizational structures and number of attending doctors in German university hospitals were examined via a website-analysis. A pubmed-analysis was applied to assess the publication performance (number of publications, cumulative impact factor, impact factor/publication, number of publications/MD, number of publications/unit) between 2009 and 2013. In a journal-analysis the distribution of the cumulative impact factor and number of publications in different journals as well as the development of the impact factor in the top-journals were analyzed.

Results: Out of all 35 university hospitals there exist 12 independent departments for plastic surgery and 8 inferior organizational structures. In 15 university hospitals there were no designated plastic surgery units. The number of attending doctors differed considerably between independent departments (3.6 attending doctors/unit) and inferior organizational structures (1.1 attending doctors/unit). The majority of publications (89.0%) and of the cumulative impact factor (91.2%) as well as most of the publications/MD (54 publications/year) and publications/unit (61 publications/year) were created within the independent departments. Only in departments top-publications with an impact factor > 5 were published. In general a negative trend regarding the number of publications (-13.4%) and cumulative impact factor (-28.9%) was observed. 58.4% of all publications were distributed over the top-10 journals. Within the latter the majority of articles were published in English journals (60% of publications, 79.9% of the cumulative impact factor). The average impact factor of the top-10-journals increased by 13.5% from 2009 - 2013.

Summary: In contrast to inferior and dependent organizational structures independent departments of plastic surgery are the key performers within German academic plastic surgery, which however suffers from a general declining publication performance. Hence, the type of organizational structure has crucial influence on the research performance.

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