Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries.
Identifieur interne : 000190 ( Main/Exploration ); précédent : 000189; suivant : 000191Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries.
Auteurs : Liesbet Van Bulck [Belgique] ; Eva Goossens [Belgique] ; Koen Luyckx [Belgique, Afrique du Sud] ; Silke Apers [Belgique] ; Erwin Oechslin [Canada] ; Corina Thomet [Suisse] ; Werner Budts [Belgique] ; Junko Enomoto [Japon] ; Maayke A. Sluman [Pays-Bas] ; Chun-Wei Lu [Taïwan] ; Jamie L. Jackson [États-Unis] ; Paul Khairy [Canada] ; Stephen C. Cook [États-Unis] ; Shanthi Chidambarathanu [Inde] ; Luis Alday [Argentine] ; Katrine Eriksen [Norvège] ; Mikael Dellborg [Suède] ; Malin Berghammer [Suède] ; Bengt Johansson [Suède] ; Andrew S. Mackie [Canada] ; Samuel Menahem [Australie] ; Maryanne Caruana [Malte] ; Gruschen Veldtman [États-Unis] ; Alexandra Soufi [France] ; Susan M. Fernandes [États-Unis] ; Kamila White [États-Unis] ; Edward Callus [Italie] ; Shelby Kutty [États-Unis] ; Philip Moons [Belgique, Suède, Afrique du Sud]Source :
- BMC health services research [ 1472-6963 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Cardiopathies congénitales (thérapie), Femelle (MeSH), Humains (MeSH), Main-d'oeuvre en santé (statistiques et données numériques), Mesures des résultats rapportés par les patients (MeSH), Mâle (MeSH), Prestations des soins de santé (organisation et administration), Santé mondiale (MeSH), Études transversales (MeSH).
- MESH :
- organisation et administration : Prestations des soins de santé.
- statistiques et données numériques : Main-d'oeuvre en santé.
- thérapie : Cardiopathies congénitales.
- Adulte, Femelle, Humains, Mesures des résultats rapportés par les patients, Mâle, Santé mondiale, Études transversales.
English descriptors
- KwdEn :
- MESH :
- organization & administration : Delivery of Health Care.
- statistics & numerical data : Health Workforce.
- therapy : Heart Defects, Congenital.
- Adult, Cross-Sectional Studies, Female, Global Health, Humans, Male, Patient Reported Outcome Measures.
Abstract
BACKGROUND
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.
DOI: 10.1186/s12913-020-05361-9
PubMed: 32493367
PubMed Central: PMC7268498
Affiliations:
- Afrique du Sud, Argentine, Australie, Belgique, Canada, France, Inde, Italie, Japon, Malte, Norvège, Pays-Bas, Suisse, Suède, Taïwan, États-Unis
- Alberta, Auvergne-Rhône-Alpes, Californie, Canton de Berne, Hollande-Septentrionale, Lombardie, Michigan, Missouri (État), Nebraska, Ohio, Ontario, Province d'Anvers, Québec, Rhône-Alpes, Région de Bruxelles-Capitale, Région flamande, Victoria (État), Østlandet
- Amsterdam, Anvers, Berne, Bruxelles, Edmonton, Lyon, Melbourne, Milan, Montréal, Oslo, Toronto
- Université d'Anvers
Links toward previous steps (curation, corpus...)
Le document en format XML
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University of Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>KU Leuven School Psychology and Development in Context, KU Leuven - University of Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>UNIBS, University of the Free State, Bloemfontein, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>UNIBS, University of the Free State, Bloemfontein</wicri:regionArea><wicri:noRegion>Bloemfontein</wicri:noRegion></affiliation></author><author><name sortKey="Apers, Silke" sort="Apers, Silke" uniqKey="Apers S" first="Silke" last="Apers">Silke Apers</name><affiliation wicri:level="1"><nlm:affiliation>Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Oechslin, Erwin" sort="Oechslin, Erwin" uniqKey="Oechslin E" first="Erwin" last="Oechslin">Erwin Oechslin</name><affiliation wicri:level="3"><nlm:affiliation>Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto</wicri:regionArea><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Thomet, Corina" sort="Thomet, Corina" uniqKey="Thomet C" first="Corina" last="Thomet">Corina Thomet</name><affiliation wicri:level="3"><nlm:affiliation>Center for Congenital Heart Disease, Inselspital - Bern University Hospital, University of Bern, Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Center for Congenital Heart Disease, Inselspital - Bern University Hospital, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Budts, Werner" sort="Budts, Werner" uniqKey="Budts W" first="Werner" last="Budts">Werner Budts</name><affiliation wicri:level="1"><nlm:affiliation>Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>KU Leuven Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>KU Leuven Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Enomoto, Junko" sort="Enomoto, Junko" uniqKey="Enomoto J" first="Junko" last="Enomoto">Junko Enomoto</name><affiliation wicri:level="1"><nlm:affiliation>Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba</wicri:regionArea><wicri:noRegion>Chiba</wicri:noRegion></affiliation></author><author><name sortKey="Sluman, Maayke A" sort="Sluman, Maayke A" uniqKey="Sluman M" first="Maayke A" last="Sluman">Maayke A. Sluman</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Cardiology, Academic Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Lu, Chun Wei" sort="Lu, Chun Wei" uniqKey="Lu C" first="Chun-Wei" last="Lu">Chun-Wei Lu</name><affiliation wicri:level="1"><nlm:affiliation>National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>National Taiwan University Hospital and Medical College, National Taiwan University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Jackson, Jamie L" sort="Jackson, Jamie L" uniqKey="Jackson J" first="Jamie L" last="Jackson">Jamie L. Jackson</name><affiliation wicri:level="2"><nlm:affiliation>Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Khairy, Paul" sort="Khairy, Paul" uniqKey="Khairy P" first="Paul" last="Khairy">Paul Khairy</name><affiliation wicri:level="3"><nlm:affiliation>Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal</wicri:regionArea><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Cook, Stephen C" sort="Cook, Stephen C" uniqKey="Cook S" first="Stephen C" last="Cook">Stephen C. Cook</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Chidambarathanu, Shanthi" sort="Chidambarathanu, Shanthi" uniqKey="Chidambarathanu S" first="Shanthi" last="Chidambarathanu">Shanthi Chidambarathanu</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai</wicri:regionArea><wicri:noRegion>Chennai</wicri:noRegion></affiliation></author><author><name sortKey="Alday, Luis" sort="Alday, Luis" uniqKey="Alday L" first="Luis" last="Alday">Luis Alday</name><affiliation wicri:level="1"><nlm:affiliation>Division of Cardiology, Hospital de Niños, Córdoba, Argentina.</nlm:affiliation><country xml:lang="fr">Argentine</country><wicri:regionArea>Division of Cardiology, Hospital de Niños, Córdoba</wicri:regionArea><wicri:noRegion>Córdoba</wicri:noRegion></affiliation></author><author><name sortKey="Eriksen, Katrine" sort="Eriksen, Katrine" uniqKey="Eriksen K" first="Katrine" last="Eriksen">Katrine Eriksen</name><affiliation wicri:level="3"><nlm:affiliation>Adult Congenital Heart Disease Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Adult Congenital Heart Disease Center, Oslo University Hospital - Rikshospitalet, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Dellborg, Mikael" sort="Dellborg, Mikael" uniqKey="Dellborg M" first="Mikael" last="Dellborg">Mikael Dellborg</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation></author><author><name sortKey="Berghammer, Malin" sort="Berghammer, Malin" uniqKey="Berghammer M" first="Malin" last="Berghammer">Malin Berghammer</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Health Sciences, University West, Trollhättan, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Health Sciences, University West, Trollhättan</wicri:regionArea><wicri:noRegion>Trollhättan</wicri:noRegion></affiliation></author><author><name sortKey="Johansson, Bengt" sort="Johansson, Bengt" uniqKey="Johansson B" first="Bengt" last="Johansson">Bengt Johansson</name><affiliation wicri:level="1"><nlm:affiliation>Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Public Health and Clinical Medicine, Umeå University, Umeå</wicri:regionArea><wicri:noRegion>Umeå</wicri:noRegion></affiliation></author><author><name sortKey="Mackie, Andrew S" sort="Mackie, Andrew S" uniqKey="Mackie A" first="Andrew S" last="Mackie">Andrew S. Mackie</name><affiliation wicri:level="3"><nlm:affiliation>Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton</wicri:regionArea><placeName><settlement type="city">Edmonton</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Menahem, Samuel" sort="Menahem, Samuel" uniqKey="Menahem S" first="Samuel" last="Menahem">Samuel Menahem</name><affiliation wicri:level="3"><nlm:affiliation>Monash Heart, Monash Medical Centre, Monash University, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Monash Heart, Monash Medical Centre, Monash University, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Caruana, Maryanne" sort="Caruana, Maryanne" uniqKey="Caruana M" first="Maryanne" last="Caruana">Maryanne Caruana</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida, Malta.</nlm:affiliation><country xml:lang="fr">Malte</country><wicri:regionArea>Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida</wicri:regionArea><wicri:noRegion>Msida</wicri:noRegion></affiliation></author><author><name sortKey="Veldtman, Gruschen" sort="Veldtman, Gruschen" uniqKey="Veldtman G" first="Gruschen" last="Veldtman">Gruschen Veldtman</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Soufi, Alexandra" sort="Soufi, Alexandra" uniqKey="Soufi A" first="Alexandra" last="Soufi">Alexandra Soufi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Fernandes, Susan M" sort="Fernandes, Susan M" uniqKey="Fernandes S" first="Susan M" last="Fernandes">Susan M. Fernandes</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children's Hospital and Stanford Health Care, Palo Alto, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children's Hospital and Stanford Health Care, Palo Alto, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="White, Kamila" sort="White, Kamila" uniqKey="White K" first="Kamila" last="White">Kamila White</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Callus, Edward" sort="Callus, Edward" uniqKey="Callus E" first="Edward" last="Callus">Edward Callus</name><affiliation wicri:level="3"><nlm:affiliation>Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Clinical Psychology Service, IRCCS Policlinico San Donato, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Kutty, Shelby" sort="Kutty, Shelby" uniqKey="Kutty S" first="Shelby" last="Kutty">Shelby Kutty</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Center University of Nebraska Medical Center/ Children's Hospital and Medical Center, Omaha, NE, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Center University of Nebraska Medical Center/ Children's Hospital and Medical Center, Omaha, NE</wicri:regionArea><placeName><region type="state">Nebraska</region></placeName></affiliation></author><author><name sortKey="Moons, Philip" sort="Moons, Philip" uniqKey="Moons P" first="Philip" last="Moons">Philip Moons</name><affiliation wicri:level="1"><nlm:affiliation>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium. philip.moons@kuleuven.be.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. philip.moons@kuleuven.be.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Institute of Health and Care Sciences, University of Gothenburg, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. philip.moons@kuleuven.be.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Department of Paediatrics and Child Health, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32493367</idno><idno type="pmid">32493367</idno><idno type="doi">10.1186/s12913-020-05361-9</idno><idno type="pmc">PMC7268498</idno><idno type="wicri:Area/Main/Corpus">000154</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000154</idno><idno type="wicri:Area/Main/Curation">000154</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000154</idno><idno type="wicri:Area/Main/Exploration">000154</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries.</title><author><name sortKey="Van Bulck, Liesbet" sort="Van Bulck, Liesbet" uniqKey="Van Bulck L" first="Liesbet" last="Van Bulck">Liesbet Van Bulck</name><affiliation wicri:level="1"><nlm:affiliation>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>Research Foundation Flanders (FWO), Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Research Foundation Flanders (FWO), Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Goossens, Eva" sort="Goossens, Eva" uniqKey="Goossens E" first="Eva" last="Goossens">Eva Goossens</name><affiliation wicri:level="1"><nlm:affiliation>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>Research Foundation Flanders (FWO), Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Research Foundation Flanders (FWO), Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Division of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Luyckx, Koen" sort="Luyckx, Koen" uniqKey="Luyckx K" first="Koen" last="Luyckx">Koen Luyckx</name><affiliation wicri:level="1"><nlm:affiliation>KU Leuven School Psychology and Development in Context, KU Leuven - University of Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>KU Leuven School Psychology and Development in Context, KU Leuven - University of Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>UNIBS, University of the Free State, Bloemfontein, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>UNIBS, University of the Free State, Bloemfontein</wicri:regionArea><wicri:noRegion>Bloemfontein</wicri:noRegion></affiliation></author><author><name sortKey="Apers, Silke" sort="Apers, Silke" uniqKey="Apers S" first="Silke" last="Apers">Silke Apers</name><affiliation wicri:level="1"><nlm:affiliation>Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Oechslin, Erwin" sort="Oechslin, Erwin" uniqKey="Oechslin E" first="Erwin" last="Oechslin">Erwin Oechslin</name><affiliation wicri:level="3"><nlm:affiliation>Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto</wicri:regionArea><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Thomet, Corina" sort="Thomet, Corina" uniqKey="Thomet C" first="Corina" last="Thomet">Corina Thomet</name><affiliation wicri:level="3"><nlm:affiliation>Center for Congenital Heart Disease, Inselspital - Bern University Hospital, University of Bern, Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Center for Congenital Heart Disease, Inselspital - Bern University Hospital, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Budts, Werner" sort="Budts, Werner" uniqKey="Budts W" first="Werner" last="Budts">Werner Budts</name><affiliation wicri:level="1"><nlm:affiliation>Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>KU Leuven Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>KU Leuven Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Enomoto, Junko" sort="Enomoto, Junko" uniqKey="Enomoto J" first="Junko" last="Enomoto">Junko Enomoto</name><affiliation wicri:level="1"><nlm:affiliation>Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba</wicri:regionArea><wicri:noRegion>Chiba</wicri:noRegion></affiliation></author><author><name sortKey="Sluman, Maayke A" sort="Sluman, Maayke A" uniqKey="Sluman M" first="Maayke A" last="Sluman">Maayke A. Sluman</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Cardiology, Academic Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Lu, Chun Wei" sort="Lu, Chun Wei" uniqKey="Lu C" first="Chun-Wei" last="Lu">Chun-Wei Lu</name><affiliation wicri:level="1"><nlm:affiliation>National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>National Taiwan University Hospital and Medical College, National Taiwan University, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Jackson, Jamie L" sort="Jackson, Jamie L" uniqKey="Jackson J" first="Jamie L" last="Jackson">Jamie L. Jackson</name><affiliation wicri:level="2"><nlm:affiliation>Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Khairy, Paul" sort="Khairy, Paul" uniqKey="Khairy P" first="Paul" last="Khairy">Paul Khairy</name><affiliation wicri:level="3"><nlm:affiliation>Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal</wicri:regionArea><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Cook, Stephen C" sort="Cook, Stephen C" uniqKey="Cook S" first="Stephen C" last="Cook">Stephen C. Cook</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Chidambarathanu, Shanthi" sort="Chidambarathanu, Shanthi" uniqKey="Chidambarathanu S" first="Shanthi" last="Chidambarathanu">Shanthi Chidambarathanu</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai</wicri:regionArea><wicri:noRegion>Chennai</wicri:noRegion></affiliation></author><author><name sortKey="Alday, Luis" sort="Alday, Luis" uniqKey="Alday L" first="Luis" last="Alday">Luis Alday</name><affiliation wicri:level="1"><nlm:affiliation>Division of Cardiology, Hospital de Niños, Córdoba, Argentina.</nlm:affiliation><country xml:lang="fr">Argentine</country><wicri:regionArea>Division of Cardiology, Hospital de Niños, Córdoba</wicri:regionArea><wicri:noRegion>Córdoba</wicri:noRegion></affiliation></author><author><name sortKey="Eriksen, Katrine" sort="Eriksen, Katrine" uniqKey="Eriksen K" first="Katrine" last="Eriksen">Katrine Eriksen</name><affiliation wicri:level="3"><nlm:affiliation>Adult Congenital Heart Disease Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Adult Congenital Heart Disease Center, Oslo University Hospital - Rikshospitalet, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Dellborg, Mikael" sort="Dellborg, Mikael" uniqKey="Dellborg M" first="Mikael" last="Dellborg">Mikael Dellborg</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation></author><author><name sortKey="Berghammer, Malin" sort="Berghammer, Malin" uniqKey="Berghammer M" first="Malin" last="Berghammer">Malin Berghammer</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Health Sciences, University West, Trollhättan, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Health Sciences, University West, Trollhättan</wicri:regionArea><wicri:noRegion>Trollhättan</wicri:noRegion></affiliation></author><author><name sortKey="Johansson, Bengt" sort="Johansson, Bengt" uniqKey="Johansson B" first="Bengt" last="Johansson">Bengt Johansson</name><affiliation wicri:level="1"><nlm:affiliation>Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Public Health and Clinical Medicine, Umeå University, Umeå</wicri:regionArea><wicri:noRegion>Umeå</wicri:noRegion></affiliation></author><author><name sortKey="Mackie, Andrew S" sort="Mackie, Andrew S" uniqKey="Mackie A" first="Andrew S" last="Mackie">Andrew S. Mackie</name><affiliation wicri:level="3"><nlm:affiliation>Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton</wicri:regionArea><placeName><settlement type="city">Edmonton</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Menahem, Samuel" sort="Menahem, Samuel" uniqKey="Menahem S" first="Samuel" last="Menahem">Samuel Menahem</name><affiliation wicri:level="3"><nlm:affiliation>Monash Heart, Monash Medical Centre, Monash University, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Monash Heart, Monash Medical Centre, Monash University, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Caruana, Maryanne" sort="Caruana, Maryanne" uniqKey="Caruana M" first="Maryanne" last="Caruana">Maryanne Caruana</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida, Malta.</nlm:affiliation><country xml:lang="fr">Malte</country><wicri:regionArea>Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida</wicri:regionArea><wicri:noRegion>Msida</wicri:noRegion></affiliation></author><author><name sortKey="Veldtman, Gruschen" sort="Veldtman, Gruschen" uniqKey="Veldtman G" first="Gruschen" last="Veldtman">Gruschen Veldtman</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Soufi, Alexandra" sort="Soufi, Alexandra" uniqKey="Soufi A" first="Alexandra" last="Soufi">Alexandra Soufi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Fernandes, Susan M" sort="Fernandes, Susan M" uniqKey="Fernandes S" first="Susan M" last="Fernandes">Susan M. Fernandes</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children's Hospital and Stanford Health Care, Palo Alto, CA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children's Hospital and Stanford Health Care, Palo Alto, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="White, Kamila" sort="White, Kamila" uniqKey="White K" first="Kamila" last="White">Kamila White</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Callus, Edward" sort="Callus, Edward" uniqKey="Callus E" first="Edward" last="Callus">Edward Callus</name><affiliation wicri:level="3"><nlm:affiliation>Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Clinical Psychology Service, IRCCS Policlinico San Donato, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Kutty, Shelby" sort="Kutty, Shelby" uniqKey="Kutty S" first="Shelby" last="Kutty">Shelby Kutty</name><affiliation wicri:level="2"><nlm:affiliation>Adult Congenital Heart Disease Center University of Nebraska Medical Center/ Children's Hospital and Medical Center, Omaha, NE, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Adult Congenital Heart Disease Center University of Nebraska Medical Center/ Children's Hospital and Medical Center, Omaha, NE</wicri:regionArea><placeName><region type="state">Nebraska</region></placeName></affiliation></author><author><name sortKey="Moons, Philip" sort="Moons, Philip" uniqKey="Moons P" first="Philip" last="Moons">Philip Moons</name><affiliation wicri:level="1"><nlm:affiliation>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium. philip.moons@kuleuven.be.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. philip.moons@kuleuven.be.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Institute of Health and Care Sciences, University of Gothenburg, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. philip.moons@kuleuven.be.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Department of Paediatrics and Child Health, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC health services research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Cross-Sectional Studies (MeSH)</term><term>Delivery of Health Care (organization & administration)</term><term>Female (MeSH)</term><term>Global Health (MeSH)</term><term>Health Workforce (statistics & numerical data)</term><term>Heart Defects, Congenital (therapy)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Patient Reported Outcome Measures (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Cardiopathies congénitales (thérapie)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Main-d'oeuvre en santé (statistiques et données numériques)</term><term>Mesures des résultats rapportés par les patients (MeSH)</term><term>Mâle (MeSH)</term><term>Prestations des soins de santé (organisation et administration)</term><term>Santé mondiale (MeSH)</term><term>Études transversales (MeSH)</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Prestations des soins de santé</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Delivery of Health Care</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Health Workforce</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Main-d'oeuvre en santé</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Heart Defects, Congenital</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Cardiopathies congénitales</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cross-Sectional Studies</term><term>Female</term><term>Global Health</term><term>Humans</term><term>Male</term><term>Patient Reported Outcome Measures</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Femelle</term><term>Humains</term><term>Mesures des résultats rapportés par les patients</term><term>Mâle</term><term>Santé mondiale</term><term>Études transversales</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>TRIAL REGISTRATION</b></p><p>ClinicalTrials.gov: NCT02150603. Registered 30 May 2014.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32493367</PMID><DateCompleted><Year>2020</Year><Month>12</Month><Day>07</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>14</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1472-6963</ISSN><JournalIssue CitedMedium="Internet"><Volume>20</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>Jun</Month><Day>03</Day></PubDate></JournalIssue><Title>BMC health services research</Title><ISOAbbreviation>BMC Health Serv Res</ISOAbbreviation></Journal><ArticleTitle>Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries.</ArticleTitle><Pagination><MedlinePgn>496</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12913-020-05361-9</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">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.</AbstractText><AbstractText Label="METHODS" NlmCategory="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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="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.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="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.</AbstractText><AbstractText Label="TRIAL REGISTRATION" NlmCategory="BACKGROUND">ClinicalTrials.gov: NCT02150603. Registered 30 May 2014.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Van Bulck</LastName><ForeName>Liesbet</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Research Foundation Flanders (FWO), Brussels, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goossens</LastName><ForeName>Eva</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Research Foundation Flanders (FWO), Brussels, Belgium.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Luyckx</LastName><ForeName>Koen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>KU Leuven School Psychology and Development in Context, KU Leuven - University of Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>UNIBS, University of the Free State, Bloemfontein, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Apers</LastName><ForeName>Silke</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oechslin</LastName><ForeName>Erwin</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomet</LastName><ForeName>Corina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Center for Congenital Heart Disease, Inselspital - Bern University Hospital, University of Bern, Bern, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Budts</LastName><ForeName>Werner</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>KU Leuven Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Enomoto</LastName><ForeName>Junko</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sluman</LastName><ForeName>Maayke A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lu</LastName><ForeName>Chun-Wei</ForeName><Initials>CW</Initials><AffiliationInfo><Affiliation>National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jackson</LastName><ForeName>Jamie L</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khairy</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cook</LastName><ForeName>Stephen C</ForeName><Initials>SC</Initials><AffiliationInfo><Affiliation>Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chidambarathanu</LastName><ForeName>Shanthi</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alday</LastName><ForeName>Luis</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Division of Cardiology, Hospital de Niños, Córdoba, Argentina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eriksen</LastName><ForeName>Katrine</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Adult Congenital Heart Disease Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dellborg</LastName><ForeName>Mikael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Berghammer</LastName><ForeName>Malin</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Health Sciences, University West, Trollhättan, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Johansson</LastName><ForeName>Bengt</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mackie</LastName><ForeName>Andrew S</ForeName><Initials>AS</Initials><AffiliationInfo><Affiliation>Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Menahem</LastName><ForeName>Samuel</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Monash Heart, Monash Medical Centre, Monash University, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Caruana</LastName><ForeName>Maryanne</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida, Malta.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Veldtman</LastName><ForeName>Gruschen</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Soufi</LastName><ForeName>Alexandra</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fernandes</LastName><ForeName>Susan M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children's Hospital and Stanford Health Care, Palo Alto, CA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>White</LastName><ForeName>Kamila</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, MO, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Callus</LastName><ForeName>Edward</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kutty</LastName><ForeName>Shelby</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Adult Congenital Heart Disease Center University of Nebraska Medical Center/ Children's Hospital and Medical Center, Omaha, NE, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moons</LastName><ForeName>Philip</ForeName><Initials>P</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-8609-4516</Identifier><AffiliationInfo><Affiliation>KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium. philip.moons@kuleuven.be.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. philip.moons@kuleuven.be.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. philip.moons@kuleuven.be.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD)</CollectiveName></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName><AccessionNumberList><AccessionNumber>NCT02150603</AccessionNumber></AccessionNumberList></DataBank></DataBankList><GrantList CompleteYN="Y"><Grant><GrantID>0T/11/033</GrantID><Agency>Onderzoeksraad, KU Leuven</Agency><Country></Country></Grant><Grant><GrantID>20130607</GrantID><Agency>Hjärt-Lungfonden</Agency><Country></Country></Grant><Grant><GrantID>CCF2013_02</GrantID><Agency>Cardiac Children's Foundation Taiwan</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Health Serv Res</MedlineTA><NlmUniqueID>101088677</NlmUniqueID><ISSNLinking>1472-6963</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003695" MajorTopicYN="N">Delivery of Health Care</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014943" MajorTopicYN="N">Global Health</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006280" MajorTopicYN="N">Health Workforce</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006330" MajorTopicYN="N">Heart Defects, Congenital</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000071066" MajorTopicYN="Y">Patient Reported Outcome Measures</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Congenital Heart Defects</Keyword><Keyword MajorTopicYN="N">Health Resources</Keyword><Keyword MajorTopicYN="N">Healthcare workforce</Keyword><Keyword MajorTopicYN="N">Patient Reported Outcome Measures</Keyword><Keyword MajorTopicYN="N">Quality of life</Keyword><Keyword MajorTopicYN="N">Staffing</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>10</Month><Day>31</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>6</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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