Encinosa William E, Bernard Didem M
Center for Delivery, Organization and Markets, AHRQ, 540 Gaither Road, Rockville, MD 20850, USA.
Inquiry. 2005 Spring;42(1):60-72. doi: 10.5034/inquiryjrnl_42.1.60.
Hospitals recently have experienced greater financial pressures. Whether these financial pressures have led to more patient safety problems is unknown. Using the Healthcare Cost and Utilization Project (HCUP) State Inpatient Data for Florida from 1996 to 2000, this study examines whether financial pressure at hospitals is associated with increases in the rate of patient safety events (e.g., medical errors) for major surgeries. Findings show that patients have significantly higher odds of having adverse patient safety events (nursing-related patient safety events, surgery-related patient safety events, and all likely preventable patient safety events) when hospital profit margins decline over time. The finding that a within-hospital erosion of hospital operating profits increases the rate of adverse patient safety events suggests that any cost-cutting efforts be carefully designed and managed.
医院近来面临着更大的财务压力。这些财务压力是否导致了更多的患者安全问题尚不清楚。本研究利用1996年至2000年佛罗里达州的医疗成本与利用项目(HCUP)州住院患者数据,考察医院的财务压力是否与重大手术患者安全事件(如医疗差错)发生率的增加有关。研究结果表明,随着医院利润率随时间下降,患者发生不良患者安全事件(与护理相关的患者安全事件、与手术相关的患者安全事件以及所有可能可预防的患者安全事件)的几率显著更高。医院营业利润在医院内部的侵蚀会增加不良患者安全事件的发生率,这一发现表明,任何成本削减措施都应精心设计和管理。