Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts3Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts5Cardiology and Vascular Medicine Section, Department of.
Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts7currently a medical student, University of California, San Francisco.
JAMA Intern Med. 2014 Jan;174(1):61-7. doi: 10.1001/jamainternmed.2013.11537.
Hospital chief executive officers (CEOs) can shape the priorities and performance of their organizations. The degree to which their compensation is based on their hospitals' quality performance is not well known.
To characterize CEO compensation and examine its relation with quality metrics.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective observational study. Participants included 1877 CEOs at 2681 private, nonprofit US hospitals.
We used linear regression to identify hospital structural characteristics associated with CEO pay. We then determined the degree to which a hospital's performance on financial metrics, technologic metrics, quality metrics, and community benefit in 2008 was associated with CEO pay in 2009.
The CEOs in our sample had a mean compensation of $595,781 (median, $404,938) in 2009. In multivariate analyses, CEO pay was associated with the number of hospital beds overseen ($550 for each additional bed; 95% CI, 429-671; P < .001), teaching status ($425,078 more at major teaching vs nonteaching hospitals; 95% CI, 315,238-534,918; P < .001), and urban location. Hospitals with high levels of advanced technologic capabilities compensated their CEOs $135,862 more (95% CI, 80,744-190,990; P < .001) than did hospitals with low levels of technology. Hospitals with high performance on patient satisfaction compensated their CEOs $51,706 more than did those with low performance on patient satisfaction (95% CI, 15,166-88,247; P = .006). We found no association between CEO pay and hospitals' margins, liquidity, capitalization, occupancy rates, process quality performance, mortality rates, readmission rates, or measures of community benefit.
Compensation of CEOs at nonprofit hospitals was highly variable across the country. Compensation was associated with technology and patient satisfaction but not with processes of care, patient outcomes, or community benefit.
医院首席执行官（CEO）可以塑造其组织的优先事项和绩效。其薪酬在多大程度上基于医院的质量表现尚不清楚。
描述 CEO 的薪酬，并研究其与质量指标的关系。
设计、设置和参与者：回顾性观察性研究。参与者包括 2681 家美国私立非营利医院的 1877 位 CEO。
我们使用线性回归来确定与 CEO 薪酬相关的医院结构特征。然后，我们确定 2008 年医院在财务指标、技术指标、质量指标和社区效益方面的表现与 2009 年 CEO 薪酬的关联程度。
我们样本中的 CEO 在 2009 年的平均薪酬为 595781 美元（中位数为 404938 美元）。在多变量分析中，CEO 薪酬与监管的医院床位数量相关（每增加一张床位 550 美元；95%CI，429-671；P<0.001）、教学地位（主要教学医院比非教学医院多 425078 美元；95%CI，315238-534918；P<0.001）和城市位置。拥有高水平先进技术能力的医院为其 CEO 支付的薪酬高出 135862 美元（95%CI，80744-190990；P<0.001），而技术水平较低的医院则支付较少。在患者满意度方面表现较好的医院为其 CEO 支付的薪酬比表现较差的医院高出 51706 美元（95%CI，15166-88247；P=0.006）。我们没有发现 CEO 薪酬与医院的利润率、流动性、资本化、入住率、过程质量绩效、死亡率、再入院率或社区效益衡量标准之间存在关联。
非营利性医院的 CEO 薪酬在全国范围内差异很大。薪酬与技术和患者满意度有关，但与护理过程、患者结果或社区效益无关。
