Rating Hospital Performance in China: Review of Publicly Available Measures and Development of a Ranking System

Abstract

Background In China, significant emphasis and investment in health care reform since 2009 has brought with it increasing scrutiny of its public hospitals. Calls for greater accountability in the quality of hospital care have led to increasing attention toward performance measurement and the development of hospital ratings. Despite such interest, there has yet to be a comprehensive analysis of what performance information is publicly available to understand the performance of hospitals in China. Objective This study aims to review the publicly available performance information about hospitals in China to assess options for ranking hospital performance. Methods A review was undertaken to identify performance measures based on publicly available data. Following several rounds of expert consultation regarding the utility of these measures, we clustered the available options into three key areas: research and development, academic reputation, and quality and safety. Following the identification and clustering of the available performance measures, we set out to translate these into a practical performance ranking system to assess variation in hospital performance. Results A new hospital ranking system termed the China Hospital Development Index (CHDI) is thus presented. Furthermore, we used CHDI for ranking well-known tertiary hospitals in China. Conclusions Despite notable limitations, our assessment of available measures and the development of a new ranking system break new ground in understanding hospital performance in China. In doing so, CHDI has the potential to contribute to wider discussions and debates about assessing hospital performance across global health care systems.

Measuring Quality of Public Hospitals in Croatia Using a Multi-Criteria Approach

“…Hospital rankings have been designed with different goals, different domains, sources, and types of data, and with different methods. Dong et al [ 46 ] provide an overview of ranking systems in China and their goals, which include providing guidance and information to patients, measure scientific output and reputation, measure competitiveness, and measure performance. Sources of data used for hospital rankings include e.g., patient surveys, administrative databases, public reports, medical records, expert assessments, research citation databases, and self-reporting [ 46 , 47 , 48 ].…”

“…Dong et al [ 46 ] provide an overview of ranking systems in China and their goals, which include providing guidance and information to patients, measure scientific output and reputation, measure competitiveness, and measure performance. Sources of data used for hospital rankings include e.g., patient surveys, administrative databases, public reports, medical records, expert assessments, research citation databases, and self-reporting [ 46 , 47 , 48 ]. Mortality, compliance with standard procedures, length of stay, readmission, number of beds and patients, number and specialty of personnel, participation in clinical trials, timeliness, patient experience, social reputation, and many other indicators have been used for hospital ranking (e.g., [ 46 , 47 , 48 , 49 ]).…”

“…Sources of data used for hospital rankings include e.g., patient surveys, administrative databases, public reports, medical records, expert assessments, research citation databases, and self-reporting [46][47][48]. Mortality, compliance with standard procedures, length of stay, readmission, number of beds and patients, number and specialty of personnel, participation in clinical trials, timeliness, patient experience, social reputation, and many other indicators have been used for hospital ranking (e.g., [46][47][48][49]).…”

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“…After standardization, descriptive analysis was performed on the z -scores of the viewing, sharing, and reading indexes. For each domain, we incorporated the values of the z -scores of the viewing, sharing, and reading indexes into the scoring by using entropy weight, in which weights are systematically calculated based on the level of the difference between the original values ( 28 ).…”

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“…More than 200 relevant articles from journals and literature were subsequently retrospectively analyzed. [10][11][12][13][14] Keywords including "Hospital Rankings in China," "China's Best Hospital Rankings," "Chinese Hospitals' Competitiveness Rankings," and "Chinese Hospitals' Scientific Influence Rankings" were searched using the China National Knowledge Infrastructure (CNKI), PubMed, the Wan Fang resource databases, and the wiper database journal database. Additionally, our materials included some comments and content found through Sohu and Google searches.…”