Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
BMC Health Serv Res. 2021 May 31;21(1):534. doi: 10.1186/s12913-021-06498-x.
Decision-makers increasingly consider patient-reported outcomes as important measures of care quality. Studies on the importance of work-place social capital-a collective work-place resource-for the experience of care quality are lacking. We determined the association between the level of work-place social capital and patient-reported quality of care in 148 hospital sections in the Capital Region of Denmark.
This cross-sectional study combined section-level social capital from 5205 health care professionals and 23,872 patient responses about care quality. Work-place social capital encompassed three dimensions: trust, justice and collaboration. Patient-reported quality of care was measured as: overall satisfaction, patient involvement, and medical errors. Linear regression analysis and generalized linear models assessed the mean differences in patient reported experience outcomes and the risk of belonging to the lowest tertile of care quality.
A higher level of work-place social capital (corresponding to the interquartile range) was associated with higher patient-reported satisfaction and inpatient and acute care patient involvement. The risk of a section belonging to the lowest tertile of patient involvement was lower in sections with higher social capital providing inpatient (RR = 0.39, 0.19-0.81 per IQR increase) and acute care (RR = 0.53, 0.31-0.89). Patient-reported errors were fewer in acute care sections with higher social capital (RR = 0.65, 0.43 to 0.99). The risk of being in the lowest tertile of patient-reported satisfaction was supported for acute care sections (RR = 0.47, 0.28-0.79).
Although we found small absolute differences in the association between patient-reported experience measures and social capital, even a small upward shift in the distribution of social capital in the hospital sector would, at the population level, have a large positive impact on patients' care experience.
决策者越来越多地将患者报告的结果视为护理质量的重要衡量标准。关于工作场所社会资本（一种集体工作场所资源）对护理质量体验的重要性的研究还很缺乏。我们确定了丹麦首都地区 148 个医院科室的工作场所社会资本水平与患者报告的护理质量之间的关联。
这是一项横断面研究，结合了 5205 名医疗保健专业人员和 23872 名患者对护理质量的反应得出的科室层面的社会资本数据。工作场所社会资本包括三个维度：信任、公正和协作。患者报告的护理质量用以下三个方面来衡量：总体满意度、患者参与度和医疗差错。线性回归分析和广义线性模型评估了患者报告的体验结果的平均差异以及属于护理质量最低三分位的风险。
工作场所社会资本水平较高（相当于四分位距）与患者报告的满意度较高以及住院和急性护理患者参与度较高相关。社会资本较高的科室属于患者参与度最低三分位的风险较低，住院（RR=0.39，每增加一个 IQR 风险降低 19-81%）和急性护理（RR=0.53，每增加一个 IQR 风险降低 31-89%）。社会资本较高的急性护理科室患者报告的错误较少（RR=0.65，0.43-0.99）。急性护理科室患者报告的满意度较低三分位的风险得到支持（RR=0.47，0.28-0.79）。
尽管我们发现患者报告的体验措施与社会资本之间的关联存在很小的绝对差异，但即使医院部门的社会资本分布略有上升，在人群层面上也会对患者的护理体验产生巨大的积极影响。
