UQ Business School, The University of Queensland, QLD, Brisbane, 4072, Australia.
Health Care Manag Sci. 2018 Sep;21(3):401-408. doi: 10.1007/s10729-017-9393-7. Epub 2017 Feb 8.
Partial least squares structural equation modeling (PLS-SEM) has become more popular across many disciplines including health care. However, articles in health care often fail to discuss the choice of PLS-SEM and robustness testing is not undertaken. This article presents the steps to be followed in a thorough PLS-SEM analysis, and includes a conceptual comparison of PLS-SEM with the more traditional covariance-based structural equation modeling (CB-SEM) to enable health care researchers and policy makers make appropriate choices. PLS-SEM allows for critical exploratory research to lay the groundwork for follow-up studies using methods with stricter assumptions. The PLS-SEM analysis is illustrated in the context of residential aged care networks combining low-level and high-level care. Based on the illustrative setting, low-level care does not make a significant contribution to the overall quality of care in residential aged care networks. The article provides key references from outside the health care literature that are often overlooked by health care articles. Choosing between PLS-SEM and CB-SEM should be based on data characteristics, sample size, the types and numbers of latent constructs modelled, and the nature of the underlying theory (exploratory versus advanced). PLS-SEM can become an indispensable tool for managers, policy makers and regulators in the health care sector.
偏最小二乘法结构方程模型(PLS-SEM)已在包括医疗保健在内的许多学科中变得越来越流行。然而,医疗保健领域的文章往往未能讨论 PLS-SEM 的选择,也没有进行稳健性测试。本文介绍了进行全面 PLS-SEM 分析的步骤,并对 PLS-SEM 与更传统的基于协方差的结构方程模型(CB-SEM)进行了概念性比较,以使医疗保健研究人员和决策者能够做出适当的选择。PLS-SEM 允许进行关键的探索性研究,为使用更严格假设的方法进行后续研究奠定基础。PLS-SEM 分析结合低水平和高水平护理,以养老院网络为背景进行了说明。根据说明性设置,低水平护理对养老院网络的整体护理质量没有显著贡献。本文提供了医疗保健文章经常忽略的来自医疗保健文献之外的关键参考文献。在 PLS-SEM 和 CB-SEM 之间进行选择应基于数据特征、样本大小、建模的潜在结构的类型和数量以及基础理论的性质(探索性与高级性)。PLS-SEM 可以成为医疗保健部门的管理者、政策制定者和监管者不可或缺的工具。