Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries

dc.contributor.authorVan Bulck, Liesbet
dc.contributor.authorGoossens, Eva
dc.contributor.authorLuyckx, Koen
dc.contributor.authorApers, Silke
dc.contributor.authorOechslin, Erwin
dc.contributor.authorThomet, Corina
dc.contributor.authorBudts, Werner
dc.contributor.authorEnomoto, Junko
dc.contributor.authorSluman, Maayke A
dc.contributor.authorLu, Chun-Wei
dc.contributor.authorJackson, Jamie L
dc.contributor.authorKhairy, Paul
dc.contributor.authorCook, Stephen C
dc.contributor.authorChidambarathanu, Shanthi
dc.contributor.authorAlday, Luis
dc.contributor.authorEriksen, Katrine
dc.contributor.authorDellborg, Mikael
dc.contributor.authorBerghammer, Malin
dc.contributor.authorJohansson, Bengt
dc.contributor.authorMackie, Andrew S
dc.contributor.authorMenahem, Samuel
dc.contributor.authorCaruana, Maryanne
dc.contributor.authorVeldtman, Gruschen
dc.contributor.authorSoufi, Alexandra
dc.contributor.authorFernandes, Susan M
dc.contributor.authorWhite, Kamila
dc.contributor.authorCallus, Edward
dc.contributor.authorKutty, Shelby
dc.contributor.authorMoons, Philip
dc.date.accessioned2020-06-10T10:12:50Z
dc.date.available2020-06-10T10:12:50Z
dc.date.issued2020-06-03
dc.date.updated2020-06-07T03:46:18Z
dc.description.abstractBackground 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,en_US
dc.identifier.urihttps://doi.org/10.1186/s12913-020-05361-9
dc.identifier.urihttp://hdl.handle.net/11427/32061
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Paediatrics and Child Healthen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Health Services Researchen_US
dc.sourceBMC Health Services Research
dc.source.journalissue1en_US
dc.source.journalvolume20en_US
dc.source.pagination496en_US
dc.source.urihttps://bmchealthservres.biomedcentral.com/
dc.subjectCongenital Heart Defectsen_US
dc.subjectHealth Resourcesen_US
dc.subjectHealthcare workforceen_US
dc.subjectPatient Reported Outcome Measuresen_US
dc.subjectQuality of lifeen_US
dc.subjectStaffingen_US
dc.titleHealthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countriesen_US
dc.typeJournal Articleen_US
dc.typeMOOCen_US
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