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Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries.

Artikel i vetenskaplig tidskrift
Författare Liesbet Van Bulck
Eva Goossens
Koen Luyckx
Silke Apers
Erwin Oechslin
Corina Thomet
Werner Budts
Junko Enomoto
Maayke A Sluman
Chun-Wei Lu
Jamie L Jackson
Paul Khairy
Stephen C Cook
Shanthi Chidambarathanu
Luis Alday
Katrine Eriksen
Mikael Dellborg
Malin Berghammer
Bengt Johansson
Andrew S Mackie
Samuel Menahem
Maryanne Caruana
Gruschen Veldtman
Alexandra Soufi
Susan M Fernandes
Kamila White
Edward Callus
Shelby Kutty
Philip Moons
Publicerad i BMC health services research
Volym 20
Nummer/häfte 1
ISSN 1472-6963
Publiceringsår 2020
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för medicin
Institutionen för vårdvetenskap och hälsa
Språk en
Länkar dx.doi.org/10.1186/s12913-020-05361...
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Hälsovetenskaper

Sammanfattning

The relationship between healthcare system inputs (e.g., human resources and infrastructure) and mortality has been extensively studied. However, the association between healthcare system inputs and patient-reported outcomes remains unclear. Hence, we explored the predictive value of human resources and infrastructures of the countries' healthcare system on patient-reported outcomes in adults with congenital heart disease.This cross-sectional study included 3588 patients with congenital heart disease (median age = 31y; IQR = 16.0; 52% women; 26% simple, 49% moderate, and 25% complex defects) from 15 countries. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviors, and quality of life. The assessed inputs of the healthcare system were: (i) human resources (i.e., density of physicians and nurses, both per 1000 people) and (ii) infrastructure (i.e., density of hospital beds per 10,000 people). Univariable, multivariable, and sensitivity analyses using general linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences.Sensitivity analyses showed that higher density of physicians was significantly associated with better self-reported physical and mental health, less psychological distress, and better quality of life. A greater number of nurses was significantly associated with better self-reported physical health, less psychological distress, and less risky health behavior. No associations between a higher density of hospital beds and patient-reported outcomes were observed.This explorative study suggests that density of human resources for health, measured on country level, are associated with patient-reported outcomes in adults with congenital heart disease. More research needs to be conducted before firm conclusions about the relationships observed can be drawn.ClinicalTrials.gov: NCT02150603. Registered 30 May 2014.

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