Chen Alissa S, Revere Lee, Ratanatawan Alissa, Beck Christopher L, Allo Julio A
1 The University of Texas Health Science Center at Houston, TX.
2 Wingate University, Wingate, NC.
Am J Med Qual. 2019 Jul/Aug;34(4):367-375. doi: 10.1177/1062860618800586. Epub 2018 Sep 23.
Academic hospitals contribute to health care through patient care, research, and teaching; however, their outcomes may not be equivalent to nonacademic hospitals. Multivariate analysis of variance is used to compare publicly reported data on patient satisfaction, readmission rates, mortality rates, and hospital-acquired injury scores between 1906 academic and nonacademic hospitals, while controlling for hospital-level covariates. Results show that academic hospitals have higher levels of patient satisfaction on 7 of the 11 measures and are equivalent to nonacademic hospitals on the remaining 4 measures. Academic hospitals have lower pneumonia mortality rates than nonacademic hospitals, with no difference for other mortality or disease-specific readmissions. However, academic hospitals have a slightly higher overall readmission rate. Infection rates were equivalent between academic and nonacademic hospitals for central line-associated bloodstream infections, pressure ulcers, and wound dehiscence for abdominal and pelvic injuries, but academic hospitals have higher catheter-associated urinary tract infection rates.
学术型医院通过患者护理、研究和教学对医疗保健做出贡献；然而，它们的医疗结果可能与非学术型医院并不等同。使用多变量方差分析来比较1906家学术型医院和非学术型医院之间公开报告的患者满意度、再入院率、死亡率和医院获得性损伤评分数据，同时控制医院层面的协变量。结果显示，在11项指标中的7项上，学术型医院的患者满意度更高，在其余4项指标上与非学术型医院相当。学术型医院的肺炎死亡率低于非学术型医院，在其他死亡率或特定疾病再入院率方面没有差异。然而，学术型医院的总体再入院率略高。在中心静脉导管相关血流感染、压疮以及腹部和盆腔损伤的伤口裂开方面，学术型医院和非学术型医院的感染率相当，但学术型医院的导尿管相关尿路感染率更高。
