A comprehensive map of the evidence on the performance evaluation indicators of public hospitals: a scoping study and best fit framework synthesis

Abstract

IntroductionKey performance indicators are essential navigation tools for hospitals. They provide managers with valid information enabling them to identify institutional strengths and weaknesses and improve managerial performance. In this study, the synthesis of evidence relating to hospital performance indicators was carried out by means of a field review and the indicators were analyzed through the Best Fit Method.MethodsThe five-step approach of Arksey and O’Malley was used as follows: selection of the research question; search for related studies; selection and refinement of the studies; synthesis and tabulation of key information; derivation of the related summary and report. Applying the Best Fit Framework Synthesis Method, the initial themes and subthemes were created and a model of public hospitals performance evaluation finally generated.ResultsForty-nine studies were considered eligible to form part of the synthesis. The final model included the efficiency/productivity, effectiveness and financial themes. The efficiency/productivity sub-themes incorporated human resources indicators, hospital beds, costs, operating room productivity, emergency rooms, ICU, radiology, labs, technology and equipment productivity. Other sub-themes relate to general indicators such as BOR, ALS, number of outpatients and hospitalized patients. Financial themes included profit, revenue, cash flow, cost, investment, assets, debt and liquidity. Concerning effectiveness, the indicators were categorized in terms of access (equity), safety, quality and responsiveness. The accountability indicators were classified into patient-centeredness, staff orientation, and social responsibility.ConclusionHospital performance management is a multi-dimensional issue, each dimension having its own significance. Based on the evidence, indicators are dependent on the evaluation model employed, the evaluation objective, and the views of executive managers and participants in the study. Selection of the most appropriate indicators is therefore key to a comprehensive performance evaluation system.

A comprehensive environmental scanning and strategic analysis of Iranian Public Hospitals: a prospective approach

“…Another important aspect at this level is inequitable distribution of hospital beds, professional and pharmaceutical resources, reducing responsiveness and patient satisfaction. Therefore, it is substantial to revisit the resource distribution at different healthcare levels (e.g., prevention, education, and research and treatment sections) as well as managing the efficiency of resources based on referral system [7].…”

“…Organizations' environments are changing at an unprecedented rate [1], posing substantial effect on healthcare systems [2][3][4]. As healthcare systems, play a major role in social and financial development and welfare, lack of awareness of the environmental change, can result in severe health-related complications for the population health [2,[5][6][7]. Hospitals have a major role in the fairness index in healthcare [2,[5][6][7].…”

“…As healthcare systems, play a major role in social and financial development and welfare, lack of awareness of the environmental change, can result in severe health-related complications for the population health [2,[5][6][7]. Hospitals have a major role in the fairness index in healthcare [2,[5][6][7]. They are the most fundamental and expensive components of the health system, using 40% and 80% of total health sector expenses in developed and developing countries, respectively [8][9][10][11].…”

A Comprehensive Strategic Analysis of the Environmental Scanning of Iranian Public Hospitals: A Prospective Approach

“…Healthcare systems are considered as the largest economic sectors in the world, and have a major role in social development and welfare. Among this, hospitals play a key role in the fair promotion of healthcare and improvement of the fairness index in healthcare (5)(6)(7). At the same time, they are the most fundamental and expensive components of the health system, in as much as they account for 40% and 80% of total health sector expenses in developed and developing countries, respectively (8)(9)(10)(11).…”

Can Integrated Care Improve the Efficiency of Hospitals? - Research based on 200 Hospitals in China

“…[6,[8][9][10] Health systems realize their goals at all levels through enhanced hospital performance. [11] This is especially the case in China where hospitals may bene t most from IC through the provision of comprehensive and coordinated care. As shown in Fig.…”