Universität zu Köln

Nowak, Marina, Swora, Michael, Karbach, Ute ORCID: 0000-0003-3479-9474, Pfaff, Holger ORCID: 0000-0001-9154-6575 and Ansmann, Lena (2021). Associations between hospital structures, processes and patient experiences of preparation for discharge in breast cancer centers: A multilevel analysis. Health Care Manage. Rev., 46 (2). S. 98 - 111. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1550-5030

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Abstract

Background Discharge management is a central task in hospital management. Mitchell's quality health outcomes model offers a contextual framework to derive expectations about the relationship between indicators of hospital structures and processes with patient experiences of preparation for discharge. Purpose The aim is to analyze the association between hospital structures and processes with patient experiences of preparation for discharge in breast cancer centers. Methodology The data were collected between February 1 and July 31, 2014-2016, with annual cross-sectional postal surveys on patient experiences of preparation for discharge in breast cancer center hospitals in Germany. These data were combined with secondary data on hospital structures, obtained from structured quality reports 2014 and the accreditation institution certifying breast cancer centers, constituting a hierarchical data structure. A total of 10,750 newly diagnosed breast cancer patients from 67 hospitals were analyzed. Following listwise deletion, 9,762 patients could be included in linear hierarchical regression analyses. Results Patients felt better prepared for discharge in hospitals that communicate the discharge date timely to patients, with good coordinative processes, and which cooperate with two other breast cancer center hospitals. Hospital structures, size, teaching status, and ownership were not associated with the patient experiences of preparation for discharge. Conclusion The results suggest that timely and informative communication, well-organized care processes, and the network structure of centers allow for an improvement of preparation for discharge. Current and future approaches for the improvement of hospital discharge should consider the identified hospital resources. Practice Implications Hospital management should increase the focus on structured communication and coordination processes to improve the discharge process. Cooperating networks should be expanded to increase expertise and resources. Results can be generalized to other care domains with caution. Patients' characteristics should further be assessed in order to use resources efficiently.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nowak, Marina UNSPECIFIED UNSPECIFIED UNSPECIFIED Swora, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Karbach, Ute UNSPECIFIED orcid.org/0000-0003-3479-9474 UNSPECIFIED Pfaff, Holger UNSPECIFIED orcid.org/0000-0001-9154-6575 UNSPECIFIED Ansmann, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-572065
DOI:	10.1097/HMR.0000000000000237
Journal or Publication Title:	Health Care Manage. Rev.
Volume:	46
Number:	2
Page Range:	S. 98 - 111
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1550-5030
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-CARE; VOLUME; SURGERY; INTERVENTIONS; COMMUNICATION; PHYSICIANS; PATTERNS; SURVIVAL; OUTCOMES; WOMEN Multiple languages Health Policy & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57206