Health Care Manage Rev. 2023;48(4):342-351. doi: 10.1097/HMR.0000000000000382. Epub 2023 Aug 18.
Increasingly, hospitals are expected to provide patient-centered care that attends to patients' health needs, including spiritual care needs. Chaplaincy services help to meet patients' spiritual care needs, which have been shown to have a positive impact on health outcomes. Variation in the provision of chaplaincy services suggests hospitals do not uniformly conform to the expectation of making chaplaincy services available.
The aim of this study was to examine the availability and factors that influence hospitals' provision of chaplaincy services.
Data were combined from the American Hospital Association annual surveys with the Area Health Resource File at the county level from 2010 to 2019. Observations on general, acute-care community hospitals were analyzed (45,384 hospital-year observations) using logistic regression that clustered standard errors at the hospital level.
Hospitals with Joint Commission accreditation, more staffed beds, nonprofit and government ownership, teaching status, one or more intensive care units, a higher percentage of Medicare inpatient days, church affiliation, and system membership were more likely to provide chaplaincy services than their counterparts. Certification as a trauma hospital and market competition showed no influence on the provision of chaplaincy services.
The lack of chaplaincy services in many hospitals may be due to limited resources, workforce shortage, or a lack of consensus on scope and nature of chaplaincy services.
Chaplaincy services are an underutilized resource that influences patient experience, clinician burnout and turnover, and the goal of ensuring care is patient-centered. Administrators should consider stronger partnerships where services are provided; researchers and policymakers should consider how the lack of these services in some hospitals may reinforce existing health disparities.
越来越多的医院被期望提供以患者为中心的医疗服务，包括满足患者的精神需求。牧师服务有助于满足患者的精神需求，事实证明，这对健康结果有积极影响。牧师服务的提供存在差异，这表明医院并没有统一符合提供牧师服务的期望。
本研究旨在探讨医院提供牧师服务的情况以及影响因素。
数据来自 2010 年至 2019 年美国医院协会年度调查与县一级的区域卫生资源文件。使用逻辑回归对普通、急性社区医院进行分析（45384 个医院年观察值），并在医院层面上对标准误差进行聚类。
与同类医院相比，获得联合委员会认证、有更多配备床位、非营利性和政府所有、具有教学地位、拥有一个或多个重症监护病房、更高比例的医疗保险住院天数、教会隶属关系和系统成员资格的医院更有可能提供牧师服务。创伤医院认证和市场竞争对牧师服务的提供没有影响。
许多医院缺乏牧师服务，这可能是由于资源有限、劳动力短缺，或者对牧师服务的范围和性质缺乏共识。
牧师服务是一种未充分利用的资源，它影响患者体验、临床医生的倦怠和离职率，以及确保以患者为中心的护理目标。管理人员应考虑建立更强的服务合作伙伴关系；研究人员和政策制定者应考虑一些医院缺乏这些服务可能会如何加剧现有的健康差距。
