Correlation between hospital finances and quality and safety of patient care
Correlation between hospital finances and quality and safety of patient care
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DOI：
10.1371/journal.pone.0219124
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发表时间：
2019-08-16
期刊：
影响因子：
3.7
通讯作者：
McLaughlin, Colleen C.
中科院分区：
文献类型：
--
作者：
Akinleye, Dean D.;McNutt, Louise-Anne;McLaughlin, Colleen C.
背景医院在财政压力下可能会努力保持质量和病人的安全，并有更差的病人的结果相对于资源充足的医院。预测有效性差可以解释为什么以前的研究财务和质量/安全之间的关联是模棱两可的。这份手稿采用主成分分析来产生财务状况和护理质量/安全性的稳健措施，以评估我们的先验假设：医院的财务绩效与提供优质护理有关，如质量和安全流程，患者结果，和以病人为中心的护理。横断面研究调查了急诊医院的财务状况和医院质量与安全。来自医疗保险和医疗补助服务中心（CMS）成本报告的医院财务数据被用来使用主成分分析开发一个综合财务绩效评分。医院质量和患者安全是通过主成分分析得出的综合质量/安全性能评分来衡量的，采用了一系列既定的质量和安全指标，包括：风险标准化住院死亡率，30天死亡率，30天再入院的选择条件，患者安全指标住院，护理图表审查过程，CMS基于价值的采购总绩效评分和患者护理体验调查。综合财务绩效得分和综合质量/安全绩效得分之间的相关性计算采用线性回归调整医院features.ResultsAmong的108个纽约州的急性护理设施的数据，有一个明确的关系，医院的财务绩效和医院的质量/安全绩效得分（标准化相关系数0.34，p
BackgroundHospitals under financial pressure may struggle to maintain quality and patient safety and have worse patient outcomes relative to well-resourced hospitals. Poor predictive validity may explain why previous studies on the association between finances and quality/safety have been equivocal. This manuscript employs principal component analysis to produce robust measures of both financial status and quality/safety of care, to assess our a priori hypothesis: hospital financial performance is associated with the provision of quality care, as measured by quality and safety processes, patient outcomes, and patient centered care.MethodsThis 2014 cross-sectional study investigated hospital financial condition and hospital quality and safety at acute care hospitals. The hospital financial data from the Centers for Medicare and Medicaid Services (CMS) cost report were used to develop a composite financial performance score using principal component analysis. Hospital quality and patient safety were measured with a composite quality/safety performance score derived from principal component analysis, utilizing a range of established quality and safety indicators including: risk-standardized inpatient mortality, 30-day mortality, 30-day readmissions for select conditions, patient safety indicators from inpatient admissions, process of care chart reviews, CMS value-based purchasing total performance score and patient experience of care surveys. The correlation between the composite financial performance score and the composite quality/safety performance score was calculated using linear regression adjusting for hospital characteristics.ResultsAmong the 108 New York State acute care facilities for which data were available, there is a clear relationship between hospital financial performance and hospital quality/safety performance score (standardized correlation coefficient 0.34, p