Department of Strategy and Medical Planning, University Hospital Essen, Germany.
BMC Health Serv Res. 2010 May 12;10:120. doi: 10.1186/1472-6963-10-120.
Subjective parameters such as quality of life or patient satisfaction gain importance as outcome parameters and benchmarks in health care. In many countries hospitals are now undergoing accreditation as mandatory or voluntary measures. It is believed but unproven that accreditations positively influence quality of care and patient satisfaction. The present study aims to assess in a defined specialty (cardiology) the relationship between patient satisfaction (as measured by the recommendation rate) and accreditation status.
Consecutive patients discharged from 25 cardiology units received a validated patient satisfaction questionnaire. Data from 3,037 patients (response rate > 55%) became available for analysis. Recommendation rate was used as primary endpoint. Different control variables such as staffing level were considered.
The 15 accredited units did not differ significantly from the 10 non-accredited units regarding main hospital (i.e. staffing levels, no. of beds) and patient (age, gender) characteristics. The primary endpoint "recommendation rate of a given hospital" for accredited hospitals (65.6%, 95% Confidence Interval (CI) 63.4 - 67.8%) and hospitals without accreditation (65.8%, 95% CI 63.1-68.5%) was not significantly different.
Our results support the notion that - at least in the field of cardiology - successful accreditation is not linked with measurable better quality of care as perceived by the patient and reflected by the recommendation rate of a given institution. Hospital accreditation may represent a step towards quality management, but does not seem to improve overall patient satisfaction.
生活质量或患者满意度等主观参数作为医疗保健的结果参数和基准变得越来越重要。在许多国家，医院现在正在进行认证，这是强制性的或自愿的措施。人们认为，认证会对护理质量和患者满意度产生积极影响，但这尚未得到证实。本研究旨在评估在一个特定的专业领域（心脏病学）中，患者满意度（通过推荐率来衡量）与认证状态之间的关系。
从 25 个心脏病学病房出院的连续患者收到了一份经过验证的患者满意度问卷。来自 3037 名患者（响应率>55%）的数据可用于分析。推荐率被用作主要终点。考虑了不同的控制变量，如人员配备水平。
15 家获得认证的单位在主要医院（即人员配备水平、床位数量）和患者（年龄、性别）特征方面与 10 家未获得认证的单位没有显著差异。认证医院（65.6%，95%置信区间（CI）63.4-67.8%）和未获得认证医院（65.8%，95%CI 63.1-68.5%）的主要终点“给定医院的推荐率”没有显著差异。
我们的结果支持这样一种观点，即在心脏病学领域至少，成功的认证与患者感知到的可衡量的更好的护理质量没有联系，也没有反映出给定机构的推荐率。医院认证可能是质量管理的一个步骤，但似乎并不能提高整体患者满意度。
