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APHA Scientific Session and Event Listing

How do rural and urban hospital patients rate their quality of care?

Marianne Baernholdt, PhD, MPH, RN, School of Nursing, University of North Carolina at Chapel Hill and University of Virginia, 114 Jameswood, Williamsburg, VA 23185, 757 253 2317, baernholdt@virginia.edu and Barbara A. Mark, PhD, RN, FAAN, School of Nursing, The University of North Carolina at Chapel Hill, Carrington Hall, Campus Box 7460, Chapel Hill, NC 25599.

In its ninth report in the Quality Chasm series, Quality Through Collaboration. The Future of Rural Health, the Institute of Medicine notes a lack of research comparing differences in quality of health care in urban and rural populations. Given recent research linking organizational factors such as hospital characteristics and nurse work environments to quality of care, it is important to determine if these factors also play a significant role in rural settings. This study examined whether there are differences in how patients in rural and urban hospitals rate their quality of care and what factors influence quality of care. The study used 2722 patients and 3293 nurses from 150 nursing units in 75 urban hospitals and 44 nursing units in 22 rural hospitals with 99 - 450 beds, from the Outcomes Research in Nursing Administration (ORNA-II) national random sample of hospitals (1R01 NR03149). Data were collected from surveys with patients and nurses as well extracted from hospital administrative files. Hierarchical stepwise regression techniques using robust standard errors to control for non-independence of observations were used. The study found that both rural location and several organizational factors did influence how patients rated their satisfaction with nursing care and their satisfaction with how their symptoms were managed. The study's findings can aid administrators and policymakers when they consider how rural hospitals differ from urban hospitals and what modifiable organizational factors need to be addressed to improve patient satisfaction.

Learning Objectives: At the conclusion of the session, the participant (learner) will be able to

Keywords: Rural Health Care Delivery System, Nurses

Presenting author's disclosure statement:

Any relevant financial relationships? No

Performance Measurement, Reporting, and Standards in Hospital Care

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA