Nwana Nwabunie, Chan Wenyaw, Langabeer James, Kash Bita, Krause Trudy Millard
Center for Outcomes Research, Houston Methodist Hospital, Houston, TX, USA; The University of Texas Health Science Center at Houston, School of Public Health, USA.
The University of Texas Health Science Center at Houston, School of Public Health, USA.
Health Place. 2022 Nov;78:102911. doi: 10.1016/j.healthplace.2022.102911. Epub 2022 Nov 12.
An aspect of a hospital's location, such as its degree of socioeconomic disadvantage, could potentially affect quality ratings of the hospital; yet, few studies have granularly explored this relationship in United States (US) metropolitan areas characterized by a wide breadth of socioeconomic disparities across neighborhoods. An understanding of the effect of neighborhood socioeconomic disadvantage on hospital quality of care is informative for targeting resources in poor neighborhoods. We assessed the association of neighborhood socioeconomic disadvantage with hospital quality of care across several areas of quality (including mortality, readmission, safety, patient experience, effectiveness of care, summary and overall star rating) in US metropolitan areas. Hospitals in the most disadvantaged neighborhoods, compared to hospitals in the least disadvantaged neighborhoods, had worse mortality scores, readmission scores, safety of care scores, patient experience of care scores, effectiveness of care scores, summary scores and overall star rating. Timeliness of care and efficient use of imaging scores were not strongly associated with neighborhood socioeconomic disadvantage; although, future studies are needed to validate this finding. Policymakers could target innovative strategies for improving neighborhood socioeconomic conditions in more disadvantaged areas, as this may improve hospital quality.
医院位置的一个方面,比如其社会经济劣势程度,可能会影响医院的质量评级;然而,在美国大都市地区,很少有研究细致地探究这种关系,这些地区各社区的社会经济差距很大。了解社区社会经济劣势对医院医疗质量的影响,有助于在贫困社区合理分配资源。我们评估了美国大都市地区社区社会经济劣势与医院在多个质量领域(包括死亡率、再入院率、安全性、患者体验、医疗效果、综合评分和总体星级评定)的医疗质量之间的关联。与最不具社会经济劣势社区的医院相比,最具社会经济劣势社区的医院在死亡率得分、再入院得分、医疗安全得分、患者护理体验得分、医疗效果得分、综合得分和总体星级评定方面表现更差。医疗及时性和影像使用效率得分与社区社会经济劣势的关联并不紧密;不过,未来还需要开展研究来验证这一发现。政策制定者可以针对改善更贫困地区的社区社会经济状况制定创新策略,因为这可能会提高医院质量。