A Race to the Top? Competitive Pressure and Magnet Adoption Among US Hospitals 1997-2012.
A Race to the Top? Competitive Pressure and Magnet Adoption Among US Hospitals 1997-2012.
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力争上游？
DOI：
10.1097/mlr.0000000000000650
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发表时间：
2017
期刊：
影响因子：
3
通讯作者：
McHugh,Matthew
中科院分区：
文献类型：
--
作者：
Richards,MichaelR;Lasater,Karen;McHugh,Matthew
背景：护理质量仍然是美国医疗保健的焦点。质量创新之一是医院的磁铁识别计划，这是一个护士驱动的倡议，强调护理和病人安全的改善。到目前为止，磁铁医院已经与更好的结果，但它们的分布是非常不均衡的。与此相关，很少有研究的特点是什么因素驱动磁铁采用（例如，来自其他医院的竞争压力）。目的：为了研究医院是否响应更多的竞争医院成为磁铁也成为磁铁institutions.Research设计：我们使用纵向数据从美国医院协会，1997年至2012年，估计医院级固定效应回归，以捕捉磁铁采用竞争对手之间的关联和医院自己的可能性成为磁铁。我们还探讨异质性的关系，根据医院的地位在其market.Results：有更多的竞争对手成为磁铁强烈预测，一个给定的医院寻求磁铁recognition;然而，医院的市场地位和普遍的竞争水平是moderating influences.Conclusions：一个大型的文献链接磁铁医院更好的结果为患者和护士，最近的证据表明，成为磁铁的商业案例。我们发现有证据表明，医院似乎受到竞争压力的激励，这表明在决定投资于昂贵的医疗改进时有经济考虑。
Background:Care quality continues to be a focal point within US health care. One quality innovation is the Magnet recognition program for hospitals, which is a nurse-driven initiative emphasizing care and patient-safety improvements. To date, Magnet hospitals have been associated with better outcomes, but their distribution is highly uneven. Relatedly, little research has characterized what factors drive Magnet adoption (eg, competitive pressure from other hospitals).Objective:To examine if hospitals respond to more competing hospitals becoming Magnets by also becoming Magnet institutions.Research Design:We use longitudinal data from the American Hospital Association, 1997–2012, and estimate hospital-level fixed-effect regressions to capture the association between Magnet adoption among competitors and a hospital’s own likelihood of becoming a Magnet. We also explore heterogeneity in the relationships according to a hospital’s standing within its market.Results:Having more competitors become Magnets strongly predicts that a given hospital seeks Magnet recognition; yet, a hospital’s market position and prevailing competition levels are moderating influences.Conclusions:A large literature links Magnet hospitals with better outcomes for patients and nurses, and more recent evidence suggests a business case for becoming a Magnet. We find evidence that hospitals seem motivated by competitive pressure, which suggests economic considerations in the decision to invest in costly care improvements.