Hospital accreditation impact on healthcare quality dimensions: a systematic review



Linha de Pesquisa
Tomada de Decisão, Comportamento e Ética

Claudia A. S. Araujo, Marina Martins Siqueira, Ana Maria Malik



International Journal for Quality in Health Care, v. 32, n. 8, pp. 531–544. Abstract Purpose: To systematically review the impact of hospital accreditation on healthcare quality indicators, as classified into seven healthcare quality dimensions. Data source: We searched eight databases in June 2020: EBSCO, PubMed, Web of Science, Emerald, ProQuest, Science Direct, Scopus and Virtual Health Library. Search terms were conceptualized into three groups: hospitals, accreditation and terms relating to healthcare quality. The eligibility criteria included academic articles that applied quantitative methods to examine the impact of hospital accreditation on healthcare quality indicators. Study selection: We applied the PICO framework to select the articles according to the following criteria: Population—all types of hospitals; Intervention—hospital accreditation; Comparison—quantitative method applied to compare accredited vs. nonaccredited hospitals, or hospitals before vs. after accreditation; Outcomes—regarding the seven healthcare quality dimensions. After a critical appraisal of the 943 citations initially retrieved, 36 studies were included in this review. Results of data synthesis: Overall results suggest that accreditation may have a positive impact on efficiency, safety, effectiveness, timeliness and patient-centeredness. In turn, only one study analyzes the impact on access, and no study has investigated the impact on equity dimension yet. Conclusion: Mainly due to the methodological shortcomings, the positive impact of accreditation on healthcare dimensions should be interpreted with caution. This study provides an up-to-date overview of the main themes examined in the literature, highlighting critical knowledge-gaps and methodological flaws. The findings may provide value to healthcare stakeholders in terms of improving their ability to assess the relevance of accreditation processes.

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