Marshall Lindsey, Harbin Vanessa, Hooker Jane, Oswald John, Cummings Linda
National Public Health and Hospital Institute.
J Healthc Qual. 2012 Mar-Apr;34(2):21-31. doi: 10.1111/j.1945-1474.2011.00186.x. Epub 2011 Dec 22.
Several studies have found poor or mixed performance by safety net hospitals on national measures of quality. The study's purposes were to determine whether safety net hospital performance is similar to the average U.S. hospital, both currently and during earlier reporting periods, and to summarize features commonly used to assess performance, including definition of safety net and patient characteristics. This study reviewed quality performance data for the Joint Commission's accountability measures for hospitals that are members of the National Association of Public Hospitals and Health Systems (NAPH)-safety net hospitals that serve a large proportion of Medicaid and uninsured patients. Analyses of quality performance on the earliest data show that on average there was no statistically significant difference in performance between NAPH members and other hospitals on 6 of 15 measures. According to the most recent data, NAPH hospitals on average had no statistically significant differences as other hospitals on 13 of 18 measures and had statistically significantly better scores on two measures. These results are an important addition to the literature regarding safety net hospitals that serve a high proportion of Medicaid, low income, and uninsured patients, and support the case that quality of care at safety net hospitals is equivalent to that of non-safety net hospitals.
多项研究发现，安全网医院在全国性质量指标方面表现不佳或参差不齐。该研究的目的是确定安全网医院目前以及在早期报告期的表现是否与美国医院平均水平相似，并总结常用于评估表现的特征，包括安全网的定义和患者特征。本研究回顾了美国公立医院与卫生系统协会（NAPH）成员医院（即服务大量医疗补助计划患者和未参保患者的安全网医院）的联合委员会医院问责制质量表现数据。对最早数据的质量表现分析表明，在15项指标中的6项上，NAPH成员医院与其他医院在表现上平均没有统计学上的显著差异。根据最新数据，在18项指标中的13项上，NAPH医院与其他医院平均没有统计学上的显著差异，在两项指标上得分在统计学上显著更高。这些结果是有关服务大量医疗补助计划、低收入和未参保患者的安全网医院文献的重要补充，并支持了安全网医院的护理质量等同于非安全网医院这一观点。
