Sjetne Ingeborg S, Veenstra Marijke, Stavem Knut
Norwegian Knowledge Centre for the Health Services, Institute of Nursing and Health Sciences, University of Oslo, and Biostatistics, Rikshospitalet University Hospital, Oslo, Norway.
Med Care. 2007 Mar;45(3):252-8. doi: 10.1097/01.mlr.0000252162.78915.62.
Hospitals rapidly change structure and organization. Little research has been conducted that documents whether hospital size and teaching status is associated with patient experiences.
We sought to assess the effect of hospital size and teaching status on patient experiences with hospital care.
We undertook a cross-sectional survey of patients discharged from somatic hospitals in Norway. Multilevel regression analysis was used to assess the effect of interest. A total of 21,445 patients from 50 hospitals, categorized as small (36-85 beds, n=17), medium-sized (88-218 beds, n=17), large, nonteaching hospitals (226-725 beds, n=10), and large, teaching hospitals (380-997 beds, n=6) were studied. We used the Patients' Experiences Questionnaire (PEQ), which contains 10 scales measuring different aspects of hospital care.
In general, the 10,626 respondents (50% response) rated their experiences as positive. Intraclass correlation ranged from 0.23% (Scale Information About Examinations) to 6.5% (Scale Hospital and Equipment), indicating that a small to modest proportion of the variance was at the hospital level. On 5 of the 10 PEQ scales, a statistically significant part of the variance between hospitals was attributed to hospital category. Small hospitals received the highest ratings and large, teaching hospitals the lowest. Patient characteristics and hospital category contributed together to a proportional reduction in variance ranging from 7.6% (Hospital and Equipment scale) to 53.1% (Hospital Organization scale).
The effect of hospital category on patient experiences with hospital care was small. Hospital category was not a major determinant of patient experiences during hospitalization.
医院的结构和组织变化迅速。很少有研究记录医院规模和教学地位是否与患者体验相关。
我们试图评估医院规模和教学地位对患者住院护理体验的影响。
我们对挪威躯体医院出院患者进行了横断面调查。采用多水平回归分析来评估感兴趣的效应。共研究了来自50家医院的21445名患者，这些医院分为小型医院（36 - 85张床位，n = 17）、中型医院（88 - 218张床位，n = 17）、大型非教学医院（226 - 725张床位，n = 10）和大型教学医院（380 - 997张床位，n = 6）。我们使用了患者体验问卷（PEQ），该问卷包含10个量表，用于测量医院护理的不同方面。
总体而言，10626名受访者（回复率50%）对他们的体验给予了积极评价。组内相关系数范围从0.23%（检查信息量表）到6.5%（医院与设备量表），表明医院层面的方差占比小到适中。在10个PEQ量表中的5个上，医院之间方差的统计学显著部分归因于医院类别。小型医院获得的评分最高，大型教学医院最低。患者特征和医院类别共同导致方差按比例减少，范围从7.6%（医院与设备量表）到53.1%（医院组织量表）。
医院类别对患者住院护理体验的影响较小。医院类别不是住院期间患者体验的主要决定因素。
