Yu Hyunmin, Bonett Stephen, Flores Dalmacio Dennis, Meanley Steven, Choi Seul Ki, Hanneman Tari, Bauermeister José A
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Human Rights Campaign Foundation, Washington, DC, USA.
Res Nurs Health. 2025 Feb;48(1):30-40. doi: 10.1002/nur.22422. Epub 2024 Oct 23.
LGBTQ+ individuals face discrimination in healthcare settings. Magnet hospitals have been associated with positive patient outcomes, yet it remains uncertain whether Magnet designation is associated with hospitals' LGBTQ+ inclusivity in policies and practices. This study examined 801 American hospitals across 47 states that participated in the Healthcare Equality Index (HEI) in 2021. Multilevel modeling was utilized to investigate the association between Magnet status and HEI scores, adjusting for hospital type and state-level covariates, including LGBTQ+ inclusiveness in laws, political climate, racial/ethnic minority population, and Medicaid expansion status. Among the 801 hospitals, 32.1% (257 hospitals) held Magnet status. Magnet hospitals demonstrated higher HEI scores compared to non-Magnet hospitals (γ = 2.13, p = 0.022), despite significant variations across states (intraclass correlation = 0.22). No significant cross-level interactions were found. Overall, Magnet designation is independently associated with improved LGBTQ+ inclusivity in hospitals regardless of the state in which the hospital is located. Policymakers and healthcare leaders should consider leveraging the Magnet Recognition Program as a benchmark for promoting LGBTQ+ inclusivity within hospitals. Additionally, all healthcare institutions should prioritize comprehensive evaluations and improvements to their policies and practices to ensure inclusivity for LGBTQ+ patients.
LGBTQ+群体在医疗环境中面临歧视。磁石医院与良好的患者治疗效果相关联，但磁石认证是否与医院在政策和实践中对LGBTQ+群体的包容性相关仍不确定。本研究调查了2021年参与医疗平等指数（HEI）的47个州的801家美国医院。采用多层次建模来研究磁石状态与HEI分数之间的关联，并对医院类型和州级协变量进行了调整，这些协变量包括法律中的LGBTQ+包容性、政治氛围、种族/族裔少数群体人口以及医疗补助扩展状况。在这801家医院中，32.1%（257家医院）具有磁石状态。尽管各州之间存在显著差异（组内相关系数=0.22），但磁石医院的HEI分数高于非磁石医院（γ=2.13，p=0.022）。未发现显著的跨层次交互作用。总体而言，无论医院位于哪个州，磁石认证都与医院改善对LGBTQ+群体的包容性独立相关。政策制定者和医疗保健领导者应考虑将磁石认可计划作为促进医院内LGBTQ+群体包容性的基准。此外，所有医疗机构都应优先对其政策和实践进行全面评估和改进，以确保为LGBTQ+患者提供包容性服务。
