Abstract:
OBJECTIVE:To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. DATA SOURCES/STUDY SETTING:Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. STUDY DESIGN:Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. DATA COLLECTION:We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). PRINCIPAL FINDINGS:We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's alpha coefficients ranged from 0.50 to 0.89. CONCLUSIONS:It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Singer S,Meterko M,Baker L,Gaba D,Falwell A,Rosen Adoi
10.1111/j.1475-6773.2007.00706.xsubject
Has Abstractpub_date
2007-10-01 00:00:00pages
1999-2021issue
5eissn
0017-9124issn
1475-6773pii
HESR706journal_volume
42pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:This commentary summarizes the methods and topics addressed in the special issue of HSR focused on linkage of United States Department of Veterans Affairs (VA) and non-VA datasets. The issue illustrates that researchers are increasingly linking diverse datasets as a valuable method for obtaining outcomes, tre...
journal_title:Health services research
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doi:10.1111/1475-6773.13081
更新日期:2018-12-01 00:00:00
abstract::Two indexes are described, based on measures of administrative effectiveness and patient care effectiveness. The measures used were selected and ranked by a Delphi panel from a list of 30 measures drawn from the literature. Weights were assigned by the panel to 19 selected measures. The resulting indexes did well in a...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1976-10-01 00:00:00
abstract:OBJECTIVE:To examine the implications of serious and chronic health problems on the willingness of enrollees to switch health plans if they are dissatisfied with their current arrangements. DATA SOURCE:A large (20,283 respondents) survey of employees of three national corporations committed to the model of managed com...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:The volume and cost of services consumed by persons with AIDS (PWAs) during their last months of life are examined in this study. DATA SOURCES:This study utilizes data from the AIDS Costs and Service Utilization Survey (ACSUS). The ACSUS is the most comprehensive survey of medical services that are consumed ...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:To examine the effect of the Medicare prospective payment system (PPS) for skilled nursing facilities (SNF) on the delivery of rehabilitation therapy to residents. DATA SOURCES:Resident-level data are based on the Resident Assessment Instrument Minimum Data Set for nursing facilities. All elderly residents a...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00291.x
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Patients are treated using observation services (OS) when their care needs exceed standard outpatient care (i.e., clinic or emergency department) but do not qualify for admission. Medicare and other private payers seek to limit this care setting to 48 hours. DATA SOURCE/STUDY SETTING:Healthcare Cost and Uti...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12143
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To examine the impact of mandatory HMO enrollment for Medicaid-covered pregnant women on prenatal care use, smoking, Cesarean section (C-section) use, and birth weight. DATA SOURCES/STUDY SETTING:Linked birth certificate and Medicaid enrollment data from July 1993 to June 1998 in 10 Ohio counties, 6 that imp...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00260.x
更新日期:2004-08-01 00:00:00
abstract::Organizations are increasingly becoming dynamic and unstable. This evolution has given rise to greater reliance on teams and increased complexity in terms of team composition, skills required, and degree of risk involved. High-reliability organizations (HROs) are those that exist in such hazardous environments where t...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00566.x
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To explain the association of out-of-pocket (OOP) cost, community-level factors, and individual characteristics on statin therapy nonadherence. DATA SOURCES:BlueCross BlueShield of Texas claims data for the period of 2008-2011. STUDY DESIGN:A retrospective cohort of 49,176 insured patients, aged 18-64 years...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12547
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation. DATA SOURCE:We used the Health and Retirement Study (HRS), a national ...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2004.00311.x
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVES:Methodologically sound mixed methods research can improve our understanding of health services by providing a more comprehensive picture of health services than either method can alone. This study describes the frequency of mixed methods in published health services research and compares the presence of meth...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01344.x
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:We evaluate the impact of membership in a staff-model health maintenance organization (HMO) on hospital admission rates for patients presenting to an emergency department with acute chest pain. DATA SOURCES AND STUDY SETTING:Primary prospective data were gathered from all 3,006 patients presenting with a chi...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:To examine measures of need for health care and their relationship to utilization of health services in different racial and ethnic groups in California. DATA SOURCE:Telephone interviews obtained by random-digit dialing and conducted between April 1993 and July 1993 in California, with 7,264 adults (ages 18-...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVES:Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. PRINCIPAL FINDINGS:Grantees faced common challenges, including recr...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12330
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To examine the effect of worker heterogeneity, firm size, and establishment size on the breadth of employer health insurance offerings. DATA SOURCES:The data were drawn from the 1993 Robert Wood Johnson Foundation Employer Health Insurance Survey of 22,000 business establishments selected randomly from ten s...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:Building on the original taxonomy of hospital-based health systems from 20 years ago, we develop a new taxonomy to inform emerging public policy and practice developments. DATA SOURCES:The 2016 American Hospital Association's (AHA) Annual Survey; the 2016 IQVIA Healthcare Organizations and Systems (HCOS) dat...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13621
更新日期:2021-01-11 00:00:00
abstract:OBJECTIVE:To estimate the effect of a nursing home's share of residents with a serious mental illness (SMI) on the quality of care. DATA SOURCES:Secondary nursing home level data over the period 2000 through 2008 obtained from the Minimum Data Set, OSCAR, and Medicare claims. STUDY DESIGN:We employ an instrumental va...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12023
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To develop a scale to measure patients' trust in health insurers, including public and private insurers and both indemnity and managed care. A scale was developed based on our conceptual model of insurer trust. The scale was analyzed for its factor structure, internal consistency, construct validity, and othe...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To develop and test predictive models of housing instability and homelessness based on responses to a brief screening instrument administered throughout the Veterans Health Administration (VHA). DATA SOURCES/STUDY SETTING:Electronic medical record data from 5.8 million Veterans who responded to the VHA's Hom...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.13050
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To test the accuracy of various physicians' participation in Medicaid models. DATA SOURCES/STUDY SETTING:Primary data on 221 obstetricians and gynecologists in the Chicago area by telephone interviews over a four-month period. These data were combined with secondary data from the American Medical Association...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To examine financial and nonfinancial access to care and utilization of primary health care services among children of working low-income families earning below 200 percent of the federal poverty level in California, and to compare them to children in nonworking low-income families and in families earning ove...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
abstract:INTRODUCTION:America's community health centers (HCs) are uniquely poised to implement the patient-centered medical home (PCMH) model, as they are effective in providing comprehensive, accessible, and continuous primary care. This study aims to evaluate the relationship between PCMH recognition in HCs and clinical perf...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12523
更新日期:2017-06-01 00:00:00
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journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To examine whether disparities in health care experiences of Medicare beneficiaries differ between managed care (Medicare Advantage [MA]) and traditional fee-for-service (FFS) Medicare. DATA SOURCES:132,937 MA and 201,444 FFS respondents to the 2007 Medicare Consumer Assessment of Health Care Providers and S...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/j.1475-6773.2011.01245.x
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To analyze the relationship between mental health and savings and compare it to the relationship between common chronic physical conditions and savings. DATA SOURCE:Healthcare for Communities, a national survey conducted in 1997/1998 with approximately 10,000 respondents. STUDY DESIGN:We used logistic regre...
journal_title:Health services research
pub_type: 杂志文章
doi:
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:To test the effectiveness of financial incentives for smoking cessation in the Medicaid population. DATA SOURCES:Secondary data from the Medicaid Incentives for Prevention of Chronic Disease (MIPCD) program and Medicaid claims/encounter data from 2010 to 2015 for five states. STUDY DESIGN:Beneficiaries were...
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更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To determine the impact of rising health insurance premiums on coverage rates. DATA SOURCES & STUDY SETTING:Our analysis is based on two cohorts of nonelderly Americans residing in 64 large metropolitan statistical areas (MSAs) surveyed in the Current Population Survey in 1989-1991 and 1998-2000. Measures of...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1475-6773.2005.00409.x
更新日期:2005-08-01 00:00:00
abstract:CONTEXT:A1c levels are widely used to assess quality of diabetes care provided by health care systems. Currently, cross-sectional measures are commonly used for such assessments. OBJECTIVE:To study within-patient longitudinal changes in A1c levels at Veterans Health Administration (VHA) facilities as an alternative to...
journal_title:Health services research
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1475-6773.2005.00439.x
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:To utilize functional status (FS) outcomes to benchmark outpatient therapy clinics. DATA SOURCES:Outpatient therapy data from clinics using Focus on Therapeutic Outcomes (FOTO) assessments. STUDY DESIGN:Retrospective analysis of 538 clinics, involving 2,040 therapists and 90,392 patients admitted July 2006-...
journal_title:Health services research
pub_type: 杂志文章
doi:10.1111/1475-6773.12344
更新日期:2016-04-01 00:00:00
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journal_title:Health services research
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doi:10.1111/j.1475-6773.2006.00622.x
更新日期:2007-04-01 00:00:00