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. Author manuscript; available in PMC: 2010 Jul 15.
Published in final edited form as: Med Care. 2004 Feb;42(2 Suppl):II57–II66. doi: 10.1097/01.mlr.0000109126.50398.5a

Estimated Differences in Outcomes Between Hospital Units With Good, Mixed, and Poor Practice Environments, Under Linear and Nonlinear Models, and Information Related to the Linear Specification

Estimated Practice
Environment Effect
Dependent
Variable
Mixed
vs. Poor
Good vs.
Mixed
Improvement
Chi-Squared
Difference
Chi-Squared
Variation
Explained
Emotional exhaustion Linear model 0.59 0.59 22.6* 3.7 86%
Nonlinear model 0.86 0.43 26.3*
Depersonalization Linear model 0.68 0.68 12.0* 0.2 98%
Nonlinear model 0.74 0.64 12.2*
Personal accomplishment Linear model 0.93 0.93 0.1 0.3
Nonlinear model 1.10 0.84 0.4
Intention to leave Linear model 0.63 0.63 18.0* 0.1 99%
Nonlinear model 0.64 0.60 18.1*
Patient satisfaction Linear model 1.49 1.49 9.2* 1.2 88%
Nonlinear model 1.26 1.83 10.4*

Notes: The practice environment effect is estimated by odds ratios under the linear and nonlinear models, which indicate the differences between hospital units with mixed vs. poor environments, and good vs. mixed environments. The improvement chi-squared indicates how greatly these 2 models improve on a baseline model that includes nurse (or patient) characteristics but excludes the practice environment effect. The difference chi-squared represents the difference in the fit of the 2 models with 1 degree of freedom. The variation explained is an R-square analog obtained by dividing the improvement chi-squared for the linear model by the improvement chi-squared for the nonlinear model. Asterisks denote whether models significantly improve on the baseline model, or significantly differ from one another, at the 0.05 level.