All ETDs from UAB

Advisory Committee Chair

Nancy M Borkowski

Advisory Committee Members

Paul A Datti

Stephen J O'Connor

Robert Weech-Maldonado

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


ABSTRACT There are an increasing number of LGBT individuals who openly acknowledge their sexuality and are visibly part of society. Unfortunately, a stigma remains among this group and a fear of discrimination that prevents many individuals from seeking healthcare. This is a long-standing issue and further challenged by lack of culturally competent LGBT healthcare providers. Using a conceptual framework based on the Resource Dependence and Resource-Based theories, the association between designation as a 2016 Leader in LGBT Healthcare Equality and patient experience scores are evaluated. Regression analyses were performed to assess the association between market factors, organizational characteristics, HCAHPS survey results in “likelihood to recommend” and “percent of patients rating the hospital 9 and10” categories with hospitals earning the designation as a Leader in LGBT Healthcare Equality. Organizational variables included ownership status, system affiliation, teaching hospital, number total beds, and nurse staffing. Market factors included states collecting sexual orientation and gender identity data in 2015, percent of persons 25+ w/diploma, per capita income, metropolitan area, and proportion of racial/ethnic minorities in the area. This information will be beneficial in delivering care to the LGBT population, and subsequently influencing patient satisfaction scores. Findings from this study will inform healthcare stakeholders of the unique needs the LGBT population has and the services they seek. Opportunities for future research include evaluation of recent HEI surveys, comparison of additional HCPAHS survey categories, studies to include children’s hospitals, veterans and an assessment of out-patient facilities earning the HEI Leader designation. The results demonstrate hospitals that are system affiliated, teaching, governmental, and located in a more competitive metropolitan area were more likely to be designated as a 2016 Leader in LGBT Healthcare Equality.



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