title: Patients' assessment of quality of care in public tertiary hospitals with and without accreditation: comparative cross-sectional study.
abstract: OBJECTIVE
  To compare patients' assessment of quality of care provided by public tertiary hospitals grouped according to accreditation status.
  
  
  BACKGROUND
  Healthcare institutions worldwide are increasingly adopting accreditation as continuing initiative aimed at improving structures, processes and outcomes associated with quality of care. Patients being recipients of health care need to participate in assessing the quality of care they experienced while confined for therapeutic management.
  
  
  METHODS
  Comparative, cross-sectional.
  
  
  METHODS
  Data were collected from patients confined in public tertiary hospitals (n = 517 in four with accreditation and n = 542 in four without accreditation) in Riyadh, Saudi Arabia between February 2011-June 2011. Patients rated key performance indicators grouped under the dimensions of structure, process and outcome. Mann-Whitney U-test, Spearman Correlation Coefficient and coefficient of determination were used in analysing data.
  
  
  RESULTS
  Patients in accredited public tertiary hospitals perceived structure, outcome and overall quality of care statistically higher than patients in non-accredited hospitals. No statistical differences were found in process (access and communication) indicators. Accreditation status is marginally associated with structure; outcome; and overall quality of care. The proportion of variance in the ranks of accreditation status explained the proportion of variance in the ranks of structure; outcome; and overall quality of care.
  
  
  CONCLUSIONS
  The results apparently showed better structure, outcome and overall quality of care in accredited hospitals. Accreditation's association in the overall quality of care apparently remained unclear. Further studies are needed to appreciate the contribution of accreditation.
authors.affiliation: Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ahmad E
authors.initials: AE
authors.lastname: Aboshaiqah
authors.affiliation: Health Administration Department, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Wadi B
authors.initials: WB
authors.lastname: Alonazi
authors.affiliation: College of Nursing, King Saud University, Riyadh, Saudi Arabia. jpatalagsa@ksu.edu.sa.
authors.forename: Joel Gonzales
authors.identifier: http://orcid.org/0000-0001-6227-0223
authors.initials: JG
authors.lastname: Patalagsa
mesh_terms: D000068:Accreditation; D003430:Cross-Sectional Studies; D006761:Hospitals; D006779:Hospitals, Public; D006801:Humans; D020380:Needs Assessment; D011787:Quality of Health Care; D062606:Tertiary Care Centers
keywords: Saudi Arabia; accreditation; key performance indicators; nurses; outcome; patients; process; public tertiary hospitals; quality of health care; structure