The Effect of Hospital Size and Teaching Status on Patient Experiences With Hospital Care

Abstract

The effect of hospital category on patient experiences with hospital care was small. Hospital category was not a major determinant of patient experiences during hospitalization.

Do breast cancer patients receive less support from physicians in German hospitals with high physician workload? A multilevel analysis

“…Low betweenhospital variation is a common finding in health services research [18,39]. Nevertheless, Selby et al [44] have shown that despite low ICCs for facilities, quality improvement efforts at the facility level lead to clinically significant improvements.…”

“…The hospital-level data were supplemented with data on two hospital structural characteristics, which in many studies have proven to explain differences in outcomes of care [18,19,36]. First, as a caseload indicator, we included data on the number of surgeries performed in each hospital on newly diagnosed breast cancer patients over the previous year (dichotomized by median split).…”

“…It is therefore possible that structural conditions and the work environment influence whether a physician has enough time, energy and motivation to interact with patients in an empathic and supportive manner. The role of hospital structures and work environments has rarely been studied with regard to patientreported outcomes (PROs) [18][19][20]. Even fewer studies relate patient-physician interaction to the hospital environment [13,21,22].…”

The patient perspective of clinical training—An empirical study about patient motives to participate

“…multiple attempts at injection) [19]. Second, the perceived higher priority given to training in teaching hospitals may be translated by some patients as poor quality of care [16][17][18]. We conclude:…”

“…These studies suggest that altruistic motives apply to patient considerations to participate in clinical training [2,14,15]. But a significant number of students as well as preceptors still find that patients refuse to participate [11] because they associate clinical training with limited patient-physician continuity and increased discomfort during diagnosis and treatment [14,[16][17][18][19]. Pinnock et al [2] report that fear of emotional distress or pain can lead patients to refuse and clinical training may evoke feelings of anxiety among patients.…”