Health Administration, University of Scranton, Scranton, Pennsylvania.
School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama.
J Healthc Manag. 2020 Sep-Oct;65(5):366-377. doi: 10.1097/JHM-D-19-00177.
An increasing number of lesbian, gay, bisexual, and transgender (LGBT) individuals openly acknowledge their identity; however, the fear of discrimination prevents many from seeking healthcare-an issue challenged by a lack of culturally competent LGBT healthcare providers. With more than 4% of American adults identifying as LGBT individuals, greater attention to their needs is imperative to improve care and access for this population. This study examined organizational and market factors associated with hospitals achieving the "Leader in LGBT Healthcare Equality" (Healthcare Equality Index, HEI; HEI Leader) designation and reported patient experience scores. We found that system-affiliated hospitals have 4.16 greater odds and teaching hospitals have 2.86 greater odds of earning the HEI Leader designation compared to nonsystem and nonteaching hospitals, respectively. Governmental hospitals have 2.47 greater odds of achieving HEI Leader status, while for-profit hospitals have 86% lower odds of having HEI Leader status compared to not-for-profit hospitals. Hospitals located in a metropolitan area have 3.19 greater odds of being an HEI Leader. The percentage of minorities and per capita income in a county also demonstrated a positive association with being an HEI Leader, with odds ratios of 1.00 and 1.02, respectively, while lower education was associated with 4% lower odds of being an HEI Leader. The main finding of this study was that HEI Leader-designated hospitals reported significantly higher overall hospital rating patient experience scores (B = 1.785; p ≤ .001) as compared to non-HEI Leader hospitals. As such, participation in the HEI may be viewed as a motivation for hospitals attaining HEI Leader designation.
越来越多的女同性恋、男同性恋、双性恋和跨性别者（LGBT）公开承认自己的身份；然而，对歧视的恐惧阻止了许多人寻求医疗保健——这一问题因缺乏有文化能力的 LGBT 医疗保健提供者而受到挑战。超过 4%的美国成年人认同自己是 LGBT 者，因此，为了改善这一人群的护理和获得护理，必须更加关注他们的需求。本研究考察了与医院获得“LGBT 医疗保健平等领袖”（医疗保健平等指数，HEI；HEI 领袖）称号和报告患者体验评分相关的组织和市场因素。我们发现，与非系统和非教学医院相比，系统附属医院获得 HEI 领袖称号的可能性高出 4.16 倍，教学医院获得 HEI 领袖称号的可能性高出 2.86 倍。政府医院获得 HEI 领袖地位的可能性高出 2.47 倍，而营利性医院获得 HEI 领袖地位的可能性比非营利性医院低 86%。位于大都市区的医院成为 HEI 领袖的可能性高出 3.19 倍。一个县的少数族裔比例和人均收入也与成为 HEI 领袖呈正相关，优势比分别为 1.00 和 1.02，而较低的教育水平与成为 HEI 领袖的可能性低 4%相关。本研究的主要发现是，被评为 HEI 领袖的医院报告的整体医院评分患者体验评分显著更高（B=1.785；p≤0.001），而不是非 HEI 领袖医院。因此，参与 HEI 可能被视为医院获得 HEI 领袖称号的动机。
