The comparison of hospitals' performance indicators before and after the Iran's hospital care transformations plan

Abstract

INTRODUCTION:Hospital care transformation plan (HCTP) was implemented, in 2014, with the aim of ensuring all Iranians have fair access to hospital care, mainly in the public sector. It was assumed that HCTP would lead to increased quality and effectiveness of health care in public hospitals. To explore whether HCTP has achieved its aim, this study has investigated the impact of this plan on performance indicators (PIs) of the public hospitals.MATERIALS AND METHODS:This cross-sectional descriptive study was conducted in 2016. The study population included all hospitals in the Isfahan City. Data (10 selected PIs) were collected through formal reports which were available at the Isfahan University of Medical Sciences and analyzed using Statistical Package for Social Sciences (version 17). The statistical significant level analysis was 0.05.RESULTS:After HCTP, it was shown an increase of (1) Bed occupancy, bed turnover, occupied bed-days, inpatients visits, and number of surgeries in all types of hospitals, (2) Outpatients’ visits in all hospitals except private ones, (3) Emergency visits in public and social security hospitals, and (4) Natural deliveries in public and semi-public hospitals. Furthermore, the average length of stay and hospital mortality rate has decreased in all types of hospitals after HCTP implementation.DISCUSSION AND CONCLUSION:Although, improving PIs of hospitals were not directly stated and known objectives of HCTP implementation, it seems HCTP could improve the performance of all hospitals, including involved and noninvolved ones.

The Effects of Health Transformation Plan Implementation on the Performance Indicators of Public Hospitals

“…Similar studies conducted in the hospitals affiliated to Bushehr University of Medical Sciences (Iran) also came to the conclusion that the plan has enhanced the bed occupancy rate and the average length of stay and the bed turnover ratio has also been steadily increasing (27). Also, the results of the study by Sajadi et al (2017) showed that BOR, ALOS, and BTR indicators have been increasing since the implementation of the HSRP (28). The number of patients admitted in the clinical and para clinical sections was also one of the other indicators concerned in this study, which showed an incremental increase following the implementation of the HSRP.…”

Indicators of surgical patients after the implementation of an Internal Bed Regulation Committee in a university hospital

“…However, the mean stay is lower than in this study, ranging from 4.00 to 5.67 days (3) . The reduction of the indicator was also verified in other institutions (23,25) , showing to be a problem-solving service and reducing risks due to prolonged hospitalizations and anticipating the individuals' return to society.…”

“…Regarding the Emergency Service, the output step is due to actions which aim to organize and direct the care process, which may encompass discharge, transference to another institution, or hospital admission (2) . In this sense, there is a tendency to organize and minimize time spent in services, aiming at the fastest possible solution, both in relation to hospital discharge and accommodation of clients in nursing beds, aiming at improving quality of care and the general result (18,(21)(22)(23) .…”

Emergency Medicine Specialists’ Knowledge of Hospital Emergency Department Indicators and Their Role in Patient Treatment: A Qualitative Study

“…These days, various tools and methods are used to evaluate the performance of organizations, and if done correctly and continuously, it will improve the executive apparatus and performance and the efficiency and effectiveness of public and private sectors (9). One of the salient features of performance appraisal is that it has a quantitative aspect that converts the results and consequences of the appraisal into measurable values (10) and is a process that measures, evaluates, and judges' performance during specific periods (11). This study also showed the importance of establishing national emergency indicators in the hospital emergency department to improve services and patient satisfaction.…”