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Health Care Manage Rev. 2014 Apr-Jun;39(2):134-44. doi: 10.1097/HMR.0b013e31828dc491.

Distinct enough? A national examination of Catholic hospital affiliation and patient perceptions of care.

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  • 1Ann Kutney-Lee, PhD, RN, is Assistant Professor of Nursing, School of Nursing, University of Pennsylvania, Philadelphia. E-mail: G. J. Melendez-Torres, RN, is Graduate Student, Department of Social Policy and Intervention, University of Oxford, United Kingdom. E-mail: Matthew D. McHugh, PhD, JD, MPH, RN, FAAN, is Assistant Professor of Nursing, School of Nursing, University of Pennsylvania, Philadelphia. E-mail: Barbra Mann Wall, PhD, RN, FAAN, is Associate Professor of Nursing, University of Pennsylvania, Philadelphia. E-mail:



Catholic hospitals play a critical role in the provision of health care in the United States; yet, empirical evidence of patient outcomes in these institutions is practically absent in the literature.


The purpose of this study was to determine whether patient perceptions of care are more favorable in Catholic hospitals as compared with non-Catholic hospitals in a national sample of hospitals.


This cross-sectional secondary analysis used linked data from the 2008 American Hospital Association Annual Survey, the 2008 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, the 2008 Medicare Case Mix Index file, and the 2010 Religious Congregations and Membership Study. The study included over 3,400 hospitals nationwide, including 494 Catholic hospitals. Propensity score matching and ordinary least-squares regression models were used to examine the relationship between Catholic affiliation and various HCAHPS measures.


Our findings revealed that patients treated in Catholic hospitals appear to rate their hospital experience similar to patients treated in non-Catholic hospitals. Catholic hospitals maintain a very slight advantage above their non-Catholic peers on five HCAHPS measures related to nurse communication, receipt of discharge information, quietness of the room at night, overall rating, and recommendation of the hospital; yet, these differences were minimal.


If the survival of Catholic health care services is contingent upon how its provision of care is distinct, administrators of Catholic hospitals must show differences more clearly. Given the great importance of Catholic hospitals to the health of millions of patients in the United States, this study provides Catholic hospitals with a set of targeted areas on which to focus improvement efforts, especially in light of current pay-for-performance initiatives.

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