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Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries
KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium (BEL); Research Foundation Flanders (FWO), Brussels, Belgium (BEL).
KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium (BEL); Research Foundation Flanders (FWO), Brussels, Belgium; University of Antwerp,Division of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, Antwerp, Belgium (BEL).
KU Leuven - University of Leuven, School Psychology and Child and Adolescent Development,Leuven, Belgium (BEL); University of the Free State, UNIBS, Bloemfontein, South Africa (ZAF).
KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium (BEL).
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2020 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 20, no 1, article id 496Article in journal (Refereed) Published
Abstract [en]

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: 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: 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: 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: ClinicalTrials.gov: NCT02150603. Registered 30 May 2014.

Place, publisher, year, edition, pages
2020. Vol. 20, no 1, article id 496
Keywords [en]
Congenital Heart Defects, Health Resources, Healthcare workforce, Patient Reported Outcome Measures, Quality of life, Staffing
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-15714DOI: 10.1186/s12913-020-05361-9ISI: 000540258000007PubMedID: 32493367Scopus ID: 2-s2.0-85086062750OAI: oai:DiVA.org:hv-15714DiVA, id: diva2:1460336
Funder
Swedish Heart Lung Foundation, 20130607
Note

Funders: Research Fund – KU Leuven (Leuven, Belgium) [OT/11/033]; Cardiac Children’s Foundation (Taiwan)[CCF2013_02].

Available from: 2020-08-24 Created: 2020-08-24 Last updated: 2022-09-15Bibliographically approved

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Berghammer, Malin

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