Hospital Accreditation Impact on Healthcare Quality Dimensions: A Systematic Review.

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.

DATA EXTRACTION:

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. non-accredited 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.