NDLI: Size matters: a meta-analysis on the impact of hospital size on patient mortality.

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Size matters: a meta-analysis on the impact of hospital size on patient mortality.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Fareed, Naleef
Description	Country affiliation: United States Author Affiliation: Fareed N ( Department of Health Administration, Virginia Commonwealth University, Richmond, Virginia 23298, USA. fareedn@vcu.edu)
Abstract	OBJECTIVE: This paper seeks to understand the relationship between hospital size and patient mortality. Patient mortality has been used by several studies in the health services research field as a proxy for measuring healthcare quality. RESEARCH METHODS: A systematic review is conducted to identify studies that investigate the impact of hospital size on patient mortality. Using the findings of 21 effect sizes from 10 eligible studies, a meta-analysis is performed using a random effects model. Subgroup analyses using three factors--the measure used for hospital size, type of mortality measure used and whether mortality was adjusted or unadjusted--were utilised to investigate their moderating influence on the study's primary relationship. RESULTS: Results from this analysis indicate that big hospitals have lower odds of patient mortality versus small hospitals. Specifically, the probability of patient mortality in a big hospital, in reference to a small hospital, is 11% less. Subgroup analyses show that studies with unadjusted mortality rates have an even lower overall odds ratio of mortality versus studies with adjusted mortality rates. CONCLUSIONS: Aside from some limitations in data reporting, the findings of this paper support theoretical notions that big hospitals have lower mortality rates than small hospitals. Guidelines for better data reporting and future research are provided to further explore the phenomenon. Policy implications of this paper's findings are underscored and a sense of urgency is called for in an effort to help improve the state of a healthcare system that struggles with advancing healthcare quality.
File Format	HTM / HTML
ISSN	17441595
Issue Number	2
Journal	International Journal of Evidence-Based Healthcare
Volume Number	10
e-ISSN	17441609
Language	English
Publisher	Wolters Kluwer Health
Publisher Date	2012-06-01
Publisher Place	Australia
Access Restriction	Subscribed
Subject Keyword	Discipline Health Services Health Facility Size Statistics & Numerical Data Hospital Mortality Health Services Research Humans Quality Of Health Care Journal Article Meta-analysis Review
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health Health Policy

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