Date of Conferral

2021

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Miriam Ross

Abstract

Approximately 20% of health care-associated infections (HAIs) result from surgical site infections (SSIs), increasing health costs, morbidity, and mortality. The mandates of public reporting of HAIs through the Centers of Medicare and Medicaid Services can have consequential effects on hospitals’ reimbursement, a significant concern to health care administrators. The primary purpose of this quantitative study was to determine if urban and rural locations and the size of hospitals affect the rate of SSIs in California. The two research questions addressed whether there is an association between the rate of SSIs in urban and rural locations and the size of hospitals in California. The Donabedian model was used as the conceptual framework to examine quality of care by focusing on implementation, physical facility, and processes. Data from the California Department of Public Health was analyzed using Mann-Whitney U and Kruskal-Wallis tests to determine the association between the rate of SSIs in rural and urban locations and the size of hospitals. The 2019 data set contained 28 types of surgical procedures from 336 rural and urban hospitals in 52 California counties. A higher rate of SSIs was evident in urban than rural hospitals. The rate of SSIs was also higher in large-sized hospitals than in medium and small hospitals. Research recommendations include exploring the rate of SSIs in different regions using data obtained from hospitals. This study may serve as a guide for health care administrators to understand the interplay of the size and location of hospitals and prevalence of SSIs. This understanding may also highlight community disparities leading to positive social change through the development of programs to improve quality care, reduce financial burden, and attain patient satisfaction.

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