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首页> 外文期刊>International Journal for Quality in Health Care >Is the implementation of quality improvement methods in hospitals subject to the neighbourhood effect?
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Is the implementation of quality improvement methods in hospitals subject to the neighbourhood effect?

机译：医院实施质量改进方法是否会受到邻里效应的影响？

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摘要

Objective. Quality improvement (QI) methods have been fashionable in hospitals for decades. Previous studies have discussed the relationships between the implementation of QI methods and various external and internal factors, but there has been no examination to date of whether the neighbourhood effect influences such implementation. The aim of this study was to use a multilevel model to investigate whether and how the neighbourhood effect influences the implementation of QI methods in the hospital setting in Taiwan. Design. This is a retrospective questionnaire-based survey. Setting. All medical centres, regional hospitals and district teaching hospitals in Taiwan. Participants. Directors or persons in charge of implementing QI methods in hospitals. Intervention(s). None. Main Outcome Measure(s). The breadth and depth of QI method implementation. Results. Seventy-two of the 139 hospitals contacted returned the questionnaire, yielding a 52% response rate. The breadth and depth of QI method implementation increased over the 10-year study period, particularly between 2004 and 2006. The breadth and depth of the QI methods implemented in the participating hospitals were significantly associated with the average breadth and depth of those implemented by their competitors in the same medical area during the previous period. In addition, time was positively associated with the breadth and depth of QI method implementation. Conclusions. In summary, the findings of this study show that hospitals' QI implementation status is influenced by that of their neighbours. Hence, the neighbourhood effect is an important factor in understanding hospital behaviour.
机译：目的。质量改进（QI）方法在医院中已经流行了数十年。先前的研究已经讨论了QI方法的实现与各种外部和内部因素之间的关系，但是迄今为止，尚未检查邻域效应是否会影响这种实现。这项研究的目的是使用多层次模型来研究台湾地区医院环境中邻域效应是否以及如何影响QI方法的实施。设计。这是一项基于调查表的回顾性调查。设置。台湾的所有医疗中心，地区医院和地区教学医院。参加者在医院中实施QI方法的主管或负责人。干预措施。没有。主要观察指标）。 QI方法实现的广度和深度。结果。所联系的139家医院中有72家退回了调查表，答复率为52％。 QI方法实施的广度和深度在为期10年的研究期间有所增加，尤其是在2004年至2006年之间。参与医院实施的QI方法的广度和深度与他们所实施的QI方法的平均广度和深度显着相关上一时期在同一医疗领域的竞争对手。此外，时间与QI方法实施的广度和深度呈正相关。结论总而言之，这项研究的结果表明，医院的QI实施状态受其邻居的影响。因此，邻里效应是理解医院行为的重要因素。

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