Silvera Geoffrey A
Health Administration Program, Department of Political Science, Auburn University, Auburn, Alabama.
Qual Manag Health Care. 2017 Oct/Dec;26(4):210-217. doi: 10.1097/QMH.0000000000000148.
Previous examinations of the relationship between patient experience and patient safety initiatives find that higher patient experience evaluations correspond to reduced incidence of adverse events. Little is known, however, about the impact of hospital organizational characteristics on this relationship. The purpose of this study is to examine the degree to which hospital size moderates the relationship between patient experience and patient safety.
A lagged cross-sectional ordinary least squares regression tests a hypothesis of a diminishing effect of hospital size on the relationship between patient evaluations of their interpersonal care experience and hospital's central-line associated bloodstream infection (CLABSI) is tested on a sample of 1740 US hospitals using data compiled from Hospital Compare and the American Hospital Association.
The results find that the magnitude of the relationship between patient experience and patient safety initiatives is diminished as hospital size increases and suggest that care providers' ability to deliver care in a manner that is simultaneously responsive to individual patient needs and preferences and reliable in its avoidance of adverse events is influenced by hospital size. An additional fractional logit is presented, which accounts for restrictions in the dependent variable further support study findings.
以往关于患者体验与患者安全举措之间关系的研究发现，较高的患者体验评价与较低的不良事件发生率相关。然而，对于医院组织特征对这种关系的影响却知之甚少。本研究的目的是检验医院规模在多大程度上调节患者体验与患者安全之间的关系。
采用滞后横截面普通最小二乘法回归，对医院规模对患者人际护理体验评价与医院中心静脉导管相关血流感染（CLABSI）之间关系的递减效应假设进行检验。使用从医院比较网站和美国医院协会汇编的数据，对1740家美国医院的样本进行了测试。
结果发现，随着医院规模的增加，患者体验与患者安全举措之间关系的强度减弱，这表明护理人员以既能响应个体患者需求和偏好又能可靠避免不良事件的方式提供护理的能力受到医院规模的影响。还给出了一个额外的分数对数模型，该模型考虑了因变量的限制，进一步支持了研究结果。
