Hospital Cultural Competency Leadership and Training is Associated with Better Financial Performance

IF 1.7 4区 医学 Q3 HEALTH POLICY & SERVICES
Soumya Upadhyay, R. Weech-Maldonado, William Opoku-Agyeman
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引用次数: 2

Abstract

SUMMARY Goal: An organization’s cultural competency reflects its ongoing capacity to provide high-quality, equitable, safe, and patient-centered care. Cultural competency leadership and training (CCLT) influences organizational cultural competency, which could affect organizational performance. Policies regarding health disparities point to the need for hospitals to become culturally competent. This study aimed to explore if CCLT practices are associated with better financial performance. Methods: Using secondary data from three sources—the American Hospital Association Annual Survey, the Health Care Cost Information System, and the Area Health Resource File—a longitudinal panel study design reviewed 3,594 hospital-year observations for acute care hospitals across the United States from 2011 to 2012. CCLT, the independent variable, was measured as a summated scale of strategy, execution, implementation, and training in diversity practices. For financial performance, the operating and total margins of hospitals were measured as dependent variables. Two random-effects regression models with year- and state-fixed effects were used to examine the relationship, with hospital being the unit of analysis. Principal Findings: The descriptive statistics showed that hospitals had an average CCLT score of approximately 2 (the range was 0–4). Regression analysis indicated that an increase in the CCLT score was associated with a 0.3% and 0.4% increase in total and operating margins, respectively (p < .05). Also, with each 10 additional staffed beds, hospitals on average experienced a 0.1% increase in both total and operating margins. Overall, for-profit hospitals experienced a 2.4% higher total margin and a 4.9% higher operating margin, as compared to not-for-profit hospitals. On the contrary, government hospitals showed 1% and 5.8% lower total and operating margins, respectively. Applications to Practice: Results of our study support a business case for CCLT practices. Cultural competency makes good economic sense by helping to improve cost savings, increase market share, and enhance the efficiency of care. Therefore, healthcare leaders should consider investing in CCLT. With the growing emphasis on value-based purchasing related to patient outcomes and experience, hospitals that develop a high degree of cultural competency through CCLT can benefit from the changes in reimbursement. CCLT also affects financial performance through avoidance of costs related to employee absenteeism and turnover and improves team cohesiveness by reducing cultural conflicts. Other mechanisms by which CCLT assists in saving costs and affecting financial performance include avoidance of unnecessary readmissions and expensive hospitalizations through the proper screening of patients from diverse backgrounds. CCLT improves cultural competency and diversity management, thus creating a unique competitive advantage for hospitals.
医院文化能力领导和培训与更好的财务绩效
目标概述:一个组织的文化竞争力反映了其提供高质量、公平、安全和以患者为中心的护理的持续能力。文化能力领导与培训影响组织文化能力,进而影响组织绩效。有关保健差距的政策指出,医院需要在文化上具有竞争力。本研究旨在探讨CCLT实践是否与更好的财务绩效相关。方法:利用来自三个来源的二次数据——美国医院协会年度调查、医疗保健成本信息系统和地区卫生资源文件——纵向面板研究设计回顾了2011年至2012年美国急性护理医院的3594个医院年度观察结果。CCLT作为自变量,被衡量为多元化实践中战略、执行、实施和培训的总和。对于财务绩效,医院的营业利润率和总利润率作为因变量来衡量。以医院为分析单位,采用具有年份固定效应和状态固定效应的两个随机效应回归模型来检验两者之间的关系。主要发现:描述性统计显示,医院的CCLT平均得分约为2分(范围为0-4)。回归分析表明,CCLT评分的增加与总利润率和营业利润率分别增加0.3%和0.4%相关(p < 0.05)。此外,每增加10个床位,医院的总利润率和营业利润率平均都会增长0.1%。总体而言,与非营利性医院相比,营利性医院的总利润率高出2.4%,营业利润率高出4.9%。相反,公立医院的总利润率和营业利润率分别下降了1%和5.8%。应用于实践:我们的研究结果支持CCLT实践的商业案例。文化能力通过帮助提高成本节约、增加市场份额和提高护理效率,具有良好的经济意义。因此,医疗保健领导者应该考虑投资于CCLT。随着人们越来越重视与患者结果和体验相关的基于价值的采购,通过CCLT培养高度文化能力的医院可以从报销的变化中受益。CCLT还通过避免与员工缺勤和离职相关的成本来影响财务绩效,并通过减少文化冲突来提高团队凝聚力。CCLT协助节省成本和影响财务绩效的其他机制包括,通过对不同背景的患者进行适当筛选,避免不必要的再入院和昂贵的住院费用。CCLT提高了文化能力和多样性管理,从而为医院创造了独特的竞争优势。
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来源期刊
Journal of Healthcare Management
Journal of Healthcare Management HEALTH POLICY & SERVICES-
CiteScore
2.00
自引率
5.60%
发文量
68
期刊介绍: The Journal of Healthcare Management is the official journal of the American College of Healthcare Executives. Six times per year, JHM offers timely healthcare management articles that inform and guide executives, managers, educators, and researchers. JHM also contains regular columns written by experts and practitioners in the field that discuss management-related topics and industry trends. Each issue presents an interview with a leading executive.
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