The Contribution of Case Mix, Skill Mix and Care Processes to the Outcomes of Community Hospitals: A Population-Based Observational Study.
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ABSTRACT: Introduction
Community hospitals (CHs) could address the emerging complex care needs of patients. We investigated which characteristics of patients' and CHs affect patient outcomes, in order to identify who could benefit the most from CH care and the best skill mix to deliver this care.Methods
We analysed all elderly patients discharged from the CHs of Emilia-Romagna, Italy. CH skill mix and care processes were collected with an ad hoc survey. The primary outcome was improvement in the Barthel index (BI) on discharge. Hierarchical regression analysis was performed to test the associations under study.Results
53% of the patients had a BI improvement ≥10. After adjusting for the diverse case mix of the patients, no significant association was found between CH characteristics and BI improvement. Patient characteristics explained only a portion of the variability in CH performance.Discussion
Heterogeneity in case mix reflects the nature of CHs, which play context-specific roles as integrators between primary care services and hospitals. Residual variability in BI improvement rates across CHs might be attributed to aspects of care not detected in our survey.Conclusions
More research is needed to study the impact of CH skill mix and care processes on patient outcomes.
SUBMITTER: Pianori D
PROVIDER: S-EPMC8231454 | biostudies-literature |
REPOSITORIES: biostudies-literature
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