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

Adult Cross-Sectional Studies Delivery of Health Care / organization & administration Female Global Health Health Workforce / statistics & numerical data Heart Defects, Congenital / therapy Humans Male Patient Reported Outcome Measures
Congenital Heart Defects Health Resources Healthcare workforce Patient Reported Outcome Measures Quality of life Staffing

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
03 Jun 2020
Historique:
received: 31 10 2019
accepted: 25 05 2020
entrez: 5 6 2020
pubmed: 5 6 2020
medline: 15 12 2020
Statut: epublish

Résumé

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.

Sections du résumé

BACKGROUND BACKGROUND
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.
METHODS METHODS
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.
RESULTS RESULTS
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.
CONCLUSIONS CONCLUSIONS
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.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov: NCT02150603. Registered 30 May 2014.

Identifiants

DOI: 10.1186/s12913-020-05361-9 PMID: 32493367 PMC: PMC7268498
pubmed: 32493367
doi: 10.1186/s12913-020-05361-9
pii: 10.1186/s12913-020-05361-9
pmc: PMC7268498
doi:

Banques de données

ClinicalTrials.gov
['NCT02150603']

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

496

Subventions

Organisme : Onderzoeksraad, KU Leuven
ID : 0T/11/033
Organisme : Hjärt-Lungfonden
ID : 20130607
Organisme : Cardiac Children's Foundation Taiwan
ID : CCF2013_02

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Auteurs

Liesbet Van Bulck (L)

KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium.
Research Foundation Flanders (FWO), Brussels, Belgium.

Eva Goossens (E)

KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium.
Research Foundation Flanders (FWO), Brussels, Belgium.
Division of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium.

Koen Luyckx (K)

KU Leuven School Psychology and Development in Context, KU Leuven - University of Leuven, Leuven, Belgium.
UNIBS, University of the Free State, Bloemfontein, South Africa.

Silke Apers (S)

Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.

Erwin Oechslin (E)

Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada.

Corina Thomet (C)

Center for Congenital Heart Disease, Inselspital - Bern University Hospital, University of Bern, Bern, Switzerland.

Werner Budts (W)

Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
KU Leuven Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium.

Junko Enomoto (J)

Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.

Maayke A Sluman (MA)

Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands.

Chun-Wei Lu (CW)

National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.

Jamie L Jackson (JL)

Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA.

Paul Khairy (P)

Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Canada.

Stephen C Cook (SC)

Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.

Shanthi Chidambarathanu (S)

Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India.

Luis Alday (L)

Division of Cardiology, Hospital de Niños, Córdoba, Argentina.

Katrine Eriksen (K)

Adult Congenital Heart Disease Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway.

Mikael Dellborg (M)

Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

Malin Berghammer (M)

Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
Department of Health Sciences, University West, Trollhättan, Sweden.

Bengt Johansson (B)

Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Andrew S Mackie (AS)

Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.

Samuel Menahem (S)

Monash Heart, Monash Medical Centre, Monash University, Melbourne, Australia.

Maryanne Caruana (M)

Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida, Malta.

Gruschen Veldtman (G)

Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Alexandra Soufi (A)

Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.

Susan M Fernandes (SM)

Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children's Hospital and Stanford Health Care, Palo Alto, CA, USA.

Kamila White (K)

Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, MO, USA.

Edward Callus (E)

Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy.
Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.

Shelby Kutty (S)

Adult Congenital Heart Disease Center University of Nebraska Medical Center/ Children's Hospital and Medical Center, Omaha, NE, USA.

Philip Moons (P)

KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium. philip.moons@kuleuven.be.
Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. philip.moons@kuleuven.be.
Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. philip.moons@kuleuven.be.
ORCID: 0000-0002-8609-4516

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Healthcare system inputs and patient-reported...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études transversales › Healthcare system inputs and patient-reported...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Healthcare system inputs and patient-reported...
questionsmedicales.fr › Caractéristiques de la population › Santé › Santé mondiale › Healthcare system inputs and patient-reported...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Ressources en santé › Main-d'oeuvre en santé › Healthcare system inputs and patient-reported...
questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Malformations › Malformations cardiovasculaires › Cardiopathies congénitales › Healthcare system inputs and patient-reported...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Healthcare system inputs and patient-reported...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Enquêtes sur les soins de santé › Mesures des résultats rapportés par les patients › Healthcare system inputs and patient-reported...