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Hadian SA, Rezayatmand R, Shaarbafchizadeh N, Ketabi S, Pourghaderi AR. Hospital performance evaluation indicators: a scoping review. BMC Health Serv Res 2024; 24:561. [PMID: 38693562 PMCID: PMC11064245 DOI: 10.1186/s12913-024-10940-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/02/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Hospitals are the biggest consumers of health system budgets and hence measuring hospital performance by quantitative or qualitative accessible and reliable indicators is crucial. This review aimed to categorize and present a set of indicators for evaluating overall hospital performance. METHODS We conducted a literature search across three databases, i.e., PubMed, Scopus, and Web of Science, using possible keyword combinations. We included studies that explored hospital performance evaluation indicators from different dimensions. RESULTS We included 91 English language studies published in the past 10 years. In total, 1161 indicators were extracted from the included studies. We classified the extracted indicators into 3 categories, 14 subcategories, 21 performance dimensions, and 110 main indicators. Finally, we presented a comprehensive set of indicators with regard to different performance dimensions and classified them based on what they indicate in the production process, i.e., input, process, output, outcome and impact. CONCLUSION The findings provide a comprehensive set of indicators at different levels that can be used for hospital performance evaluation. Future studies can be conducted to validate and apply these indicators in different contexts. It seems that, depending on the specific conditions of each country, an appropriate set of indicators can be selected from this comprehensive list of indicators for use in the performance evaluation of hospitals in different settings.
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Affiliation(s)
- Shirin Alsadat Hadian
- Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Rezayatmand
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nasrin Shaarbafchizadeh
- Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Ketabi
- Department of Management, Faculty of Administrative Sciences and Economics, University of Isfahan, Isfahan, Iran
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Scanferla E, de Bienassis K, Pachoud B, Gorwood P. How subjective well-being, patient-reported clinical improvement (PROMs) and experience of care (PREMs) relate in an acute psychiatric care setting? Eur Psychiatry 2023; 66:e26. [PMID: 36797203 PMCID: PMC10044307 DOI: 10.1192/j.eurpsy.2023.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly acknowledged as critical tools for enhancing patient-centred, value-based care. However, research is lacking on the impact of using standardized patient-reported indicators in acute psychiatric care. The aim of this study was to explore whether subjective well-being indicators (generic PROMs) are relevant for evaluating the quality of hospital care, distinct from measures of symptom improvement (disease-specific PROMs) and from PREMs. METHODS Two hundred and forty-eight inpatients admitted to a psychiatric university hospital were included in the study between January and June 2021. Subjective well-being was assessed using standardized generic PROMs on well-being, symptom improvement was assessed using standardized disease-specific PROMs, and experience of care using PREMs. PROMs were completed at admission and discharge, PREMs were completed at discharge. Clinicians rated their experience of providing treatment using adapted PREMs items. RESULTS Change in subjective well-being (PROMs) at discharge was significantly (p < 0.001), but moderately (r2 = 28.5%), correlated to improvement in symptom outcomes, and weakly correlated to experience of care (PREMs) (r2 = 11.0%), the latter being weakly explained by symptom changes (r2 = 6.9%). Patients and clinicians assessed the experience of care differently. CONCLUSIONS This study supports the case for routinely measuring patients' subjective well-being to better capture the unmet needs of patients undergoing psychiatric hospital treatment, and the use of standardized patient-reported measures as key indicators of high quality of care across mental health services.
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Affiliation(s)
- Elisabetta Scanferla
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France.,Université Paris Cité, ED 450, Paris, France
| | | | | | - Philip Gorwood
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France.,Université Paris Cité, INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Paris, France
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Reach G, Bentégeat S, Mounier-Emeury I, Le Cossec B, Yesilmen S, Hirsch V, de Oliveira Granja Y, Minetti A. Pedagogical value of a hospitality awards programme. BMJ Open Qual 2019; 8:e000576. [PMID: 31637318 PMCID: PMC6768491 DOI: 10.1136/bmjoq-2018-000576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 08/08/2019] [Accepted: 08/29/2019] [Indexed: 11/25/2022] Open
Abstract
Objective Assistance Publique-Hôpitaux de Paris (AP-HP), the leading university hospital in France, proposed to offer its services to candidate on a voluntary basis for a hospitality award, certifying compliance to a 240-item home-made questionnaire designed by healthcare providers and patients’ representatives. It combined an objective examination of the services and patients’ questionnaires, covering seven domains: reception and information from admission to discharge; cleanliness, comfort and environment; proposed services (eg, access to Wi-Fi); culture, relaxation and well-being; meals; linen and relationship quality with hospital staff. The procedure was completed in two steps: an initial self-evaluation to detect improvable deficiencies, followed by an awarding visit. A service received the hospitality award if at least 80% of the reference criteria were met during this second evaluation. Here, we describe the construction of this hospitality awards programme and present a comparison of the scores obtained during the two steps. Design and methods Retrospective comparison by usual statistical tests. Setting AP-HP, grouping 39 university hospitals (21 000 beds, 8 million annual patient visits). Participants The 211 services from 29 different hospitals engaged in the procedure (2017–2019). Results Only one service did not get the award (self-evaluation 83%, visit score 79%). The score was higher during the awarding visit (89.0%±5.6%) than during self-evaluation (85.5%±4.3%, n=211, p<0.00001), with increased scores for the following domains (p<0.005): patient reception and information; cleanliness, comfort and environment; proposed services; culture, relaxation and well-being. Conclusion (1) Internal self-evaluation is feasible. (2) By diffusing criteria of hospitality, the procedure had a pedagogical value leading to rapid and significant improvements. (3) This quality assessment procedure results in an award that can be posted in the departments. By appealing to pride, this procedure should promote hospitality in hospitals.
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Affiliation(s)
- Gérard Reach
- Direction Qualité, Accueil du Patient, et Opérations, Groupe Hospitalier Hôpitaux Universitaires Paris-Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bobigny, France.,Laboratoire Éducations et Pratiques de Santé, EA 3412, Université Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Sophie Bentégeat
- Direction Patients, Usagers et Associations, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Isabelle Mounier-Emeury
- Direction Patients, Usagers et Associations, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Brigitte Le Cossec
- Direction Patients, Usagers et Associations, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sadiyé Yesilmen
- Direction Patients, Usagers et Associations, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Vincent Hirsch
- Direction Qualité, Accueil du Patient, et Opérations, Groupe Hospitalier Hôpitaux Universitaires Paris-Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Yohann de Oliveira Granja
- Direction Qualité, Accueil du Patient, et Opérations, Groupe Hospitalier Hôpitaux Universitaires Paris-Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Audrey Minetti
- Direction Qualité, Accueil du Patient, et Opérations, Groupe Hospitalier Hôpitaux Universitaires Paris-Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bobigny, France
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Kremers MNT, Zaalberg T, van den Ende ES, van Beneden M, Holleman F, Nanayakkara PWB, Haak HR. Patient's perspective on improving the quality of acute medical care: determining patient reported outcomes. BMJ Open Qual 2019; 8:e000736. [PMID: 31637327 PMCID: PMC6768353 DOI: 10.1136/bmjoq-2019-000736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/29/2019] [Accepted: 09/10/2019] [Indexed: 11/24/2022] Open
Abstract
Rationale There is an increasing societal demand for quality assurance and transparency of medical care. The American National Academy of Medicine has determined patient centredness as a quality domain for improvement of healthcare. While many of the current quality indicators are disease specific, most emergency department (ED) patients present with undifferentiated complaints. Therefore, there is a need for generic outcome measures. Our objective was to determine relevant patient reported outcomes (PROs) for quality measurement of acute care. Methods We conducted semistructured interviews in patients ≥18 years presenting at the ED for internal medicine. Patients with a cognitive impairment or language barrier were excluded. Interviews were analysed using qualitative content analysis. Results Thirty patients were interviewed. Patients reported outcomes as relevant in five domains: relief of symptoms, understanding the diagnosis, presence and understanding of the diagnostic and/or therapeutic plan, reassurance and patient experiences. Experiences were often mentioned as relevant to the perceived quality of care and appeared to influence the domain reassurance. Conclusion We determined five domains of relevant PROs in acute care. These domains will be used for developing generic patient reported measures for acute care. The patients’ perspective will be incorporated in these measures with the ultimate aim of organising truly patient-centred care at the ED.
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Affiliation(s)
- Marjolein N T Kremers
- Faculty of Health Medicine and Life Sciences, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care, Maastricht University, Maastricht, The Netherlands.,Internal Medicine, Máxima MC, Veldhoven/Eindhoven, The Netherlands
| | - Tessel Zaalberg
- Internal Medicine, Máxima MC, Veldhoven/Eindhoven, The Netherlands
| | - Eva S van den Ende
- Internal Medicine, Section Acute Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands
| | - Marlou van Beneden
- Internal Medicine, Section Acute Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands
| | - Frits Holleman
- Internal Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Prabath W B Nanayakkara
- Internal Medicine, Section Acute Medicine, Amsterdam UMC, Location VUMC, Amsterdam, The Netherlands
| | - Harm R Haak
- Faculty of Health Medicine and Life Sciences, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care, Maastricht University, Maastricht, The Netherlands.,Internal Medicine, Máxima MC, Veldhoven/Eindhoven, The Netherlands
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Rothrock NE, Kaat AJ, Vrahas MS, OʼToole RV, Buono SK, Morrison S, Gershon RC. Validation of PROMIS Physical Function Instruments in Patients With an Orthopaedic Trauma to a Lower Extremity. J Orthop Trauma 2019; 33:377-383. [PMID: 31085947 DOI: 10.1097/bot.0000000000001493] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate the reliability, convergent validity, known-groups validity, and responsiveness of the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility Computer Adaptive Test (CAT) and PROMIS Physical Function 8a Short Form. DESIGN Prospective cohort study. SETTING Two Level-I trauma centers. PATIENTS Eligible adults with an isolated lower extremity trauma injury receiving treatment were approached consecutively (n = 402 consented at time 1, median = 80 days after treatment). After 6 months, 122 (30.3%) completed another assessment. INTERVENTION Cross-sectional and longitudinal monitoring of patients. MAIN OUTCOME MEASUREMENTS Floor and ceiling effects, reliability (marginal reliability and Cronbach's alpha), convergent validity, known-groups discriminant validity (weight-bearing status and fracture severity), and responsiveness (Cohen's d effect size) were evaluated for the PROMIS Mobility CAT, PROMIS Physical Function 8a Short Form, and 5 other measures of physical function. RESULTS PROMIS PFSF8a and Foot and Ankle Ability Measure Activities of Daily Living Index had ceiling effects. Both PROMIS measures demonstrated excellent internal consistency reliability (mean marginal reliability 0.94 and 0.96; Cronbach's alpha = 0.96). Convergent validity was supported by high correlations with other measures of physical function (r = 0.70-0.87). Known-groups validity by weight-bearing status and fracture severity was supported as was responsiveness (Mobility CAT effect size = 0.81; Physical Function Short Form 8a = 0.88). CONCLUSIONS The PROMIS Mobility CAT and Physical Function 8a Short Form demonstrated reliability, convergent and known-groups discriminant validity, and responsiveness in a sample of patients with a lower extremity orthopaedic trauma injury.
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Affiliation(s)
- Nan E Rothrock
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Aaron J Kaat
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Mark S Vrahas
- Department of Orthopaedics, Cedars Sinai Medical Center, Los Angeles, CA
| | - Robert V OʼToole
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD
| | - Sarah K Buono
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Suzanne Morrison
- Harvard Medical School Orthopaedic Trauma Initiative, Harvard Medical School, Boston, MA
| | - Richard C Gershon
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
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Robertson-Malt S, Norton-Westwood D. Framework of care: communicating the structure and processes of care. INT J EVID-BASED HEA 2017; 15:82-9. [PMID: 28863087 DOI: 10.1097/XEB.0000000000000114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This article attempts to present a 'macro view' of the role and nature of an organization's Framework of Care (FrOC). This 'view' arises from a critical reflection on the available literature and the combined professional experience of the authors, who have worked in a variety of healthcare systems and settings in Australia, North America, United Kingdom, and the Middle East. BACKGROUND FrOC can be defined as the systems and processes within an organization that structure the delivery of care. These systems and processes are made evident in a series of documents, such as the Mission and Vision statement, Policies and Procedures, Standards of Care, Clinical Practice Guidelines, Clinical Pathways, and Protocols. These frameworks can provide structure for important organizational activities such as clinical audits, quality management and clinical information system (CIS) 'decision support', thereby supporting clinicians in their efforts to deliver high-quality, evidence-based care. How a healthcare organization structures its systems and processes of care directly impacts the patient and caregiver experience - made evident in patient and staff satisfaction with the services provided. RECOMMENDATIONS Mapping out and understanding an organization's FrOC is a critical first step for interprofessional teams attempting to implement evidence into practice and/or accreditation teams and expert consultants critiquing the performance of an organization.
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Claes C, Ferket N, Vandevelde S, Verlet D, De Maeyer J. Disability Policy Evaluation: Combining Logic Models and Systems Thinking. Intellect Dev Disabil 2017; 55:247-257. [PMID: 28753403 DOI: 10.1352/1934-9556-55.4.247] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Policy evaluation focuses on the assessment of policy-related personal, family, and societal changes or benefits that follow as a result of the interventions, services, and supports provided to those persons to whom the policy is directed. This article describes a systematic approach to policy evaluation based on an evaluation framework and an evaluation process that combine the use of logic models and systems thinking. The article also includes an example of how the framework and process have recently been used in policy development and evaluation in Flanders (Belgium), as well as four policy evaluation guidelines based on relevant published literature.
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Affiliation(s)
- Claudia Claes
- Claudia Claes and Neelke Ferket, University College Ghent-E-QUAL
| | - Neelke Ferket
- Claudia Claes and Neelke Ferket, University College Ghent-E-QUAL
| | | | - Dries Verlet
- Dries Verlet, Ghent University/Research Centre of the Flemish Government/Department of Public Governance and the Chancellery; and
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van Wulfften Palthe ODR, Janssen SJ, Wunder JS, Ferguson PC, Wei G, Rose PS, Yaszemski MJ, Sim FH, Boland PJ, Healey JH, Hornicek FJ, Schwab JH. What questionnaires to use when measuring quality of life in sacral tumor patients: the updated sacral tumor survey. Spine J 2017; 17:636-644. [PMID: 27856381 PMCID: PMC5539909 DOI: 10.1016/j.spinee.2016.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/23/2016] [Accepted: 11/09/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Patient-reported outcomes are becoming increasingly important when investigating results of patient and disease management. In sacral tumor, the symptoms of patients can vary substantially; therefore, no single questionnaire can adequately account for the full spectrum of symptoms and disability. PURPOSE The purpose of this study is to analyze redundancy within the current sacral tumor survey and make a recommendation for an updated version based on the results and patient and expert opinions. STUDY DESIGN/SETTING A survey study from a tertiary care orthopedic oncology referral center was used. PATIENT SAMPLE The patient sample included 70 patients with sacral tumors (78% chordoma). OUTCOME MEASURES The following 10 questionnaires included in the current sacral tumor survey were evaluated: the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Item short form, PROMIS Pain Intensity short form, PROMIS Pain Interference short form, PROMIS Neuro-QOL v1.0 Lower Extremity Function short form, PROMIS v1.0 Anxiety short form, the PROMIS v1.0 Depression short form, the International Continence Society Male short form, the Modified Obstruction-Defecation Syndrome questionnaire, the PROMIS Sexual Function Profile v1.0, and the Stoma Quality of Life tool. METHODS We performed an exploratory factor analysis to calculate the possible underlying latent traits. Spearman rank correlation coefficients were used to measure to what extent the questionnaires converged. We hypothesized the existence of six domains based on current literature: mental health, physical health, pain, gastrointestinal symptoms, sexual function, and urinary incontinence. To assess content validity, we surveyed 32 patients, 9 orthopedic oncologists, 1 medical oncologist, 1 radiation oncologist, and 1 orthopedic oncology nurse practitioner with experience in treating sacral tumor patients on the relevance of the domains. RESULTS Reliability as measured by Cronbach alpha ranged from 0.65 to 0.96. Coverage measured by floor and ceiling effects ranged from 0% to 52% and from 0% to 30%, respectively. Explanatory factor analysis identified three traits to which the questionnaires that were expected to measure a similar construct correlated the most: mental health, physical function, and pain. Content validity index demonstrated low disagreement among patients (range: 0.10-0.18) and high agreement among physicians (range: 0.91-1.0) on the relevance of the proposed domains. Social health was identified by 50% of the commenting patients as an important yet missing domain. CONCLUSIONS The current sacral tumor survey is incomplete and time-consuming, and not all surveys are appropriate for the sacral tumor population. Our recommended survey contains less than half the questions and includes the newly recognized social health domain.
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Affiliation(s)
- Olivier D R van Wulfften Palthe
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital - Harvard Medical School, Room 3.946, Yawkey Building, 55 Fruit St, Boston, MA 02114, USA.
| | - Stein J Janssen
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital - Harvard Medical School, Room 3.946, Yawkey Building, 55 Fruit St, Boston, MA 02114, USA
| | - Jay S Wunder
- University of Toronto Musculoskeletal Oncology Unit, Mount Sinai Hospital, 600 University Ave, Toronto, ON M5G 1X5, Canada
| | - Peter C Ferguson
- University of Toronto Musculoskeletal Oncology Unit, Mount Sinai Hospital, 600 University Ave, Toronto, ON M5G 1X5, Canada
| | - Guo Wei
- Department of Orthopedic Surgery, Ji Shui Tan Hospital, Beijing Medical University, 31 Xinjiekou E Rd, Xicheng Qu, Beijing Shi, China
| | - Peter S Rose
- Department of Orthopaedic Surgery, Orthopaedic Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Micheal J Yaszemski
- Department of Orthopaedic Surgery, Orthopaedic Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Franklin H Sim
- Department of Orthopaedic Surgery, Orthopaedic Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Patrick J Boland
- Department of Orthopaedic Surgery, Orthopaedic Surgical Oncology, Memorial Sloan Kettering Cancer Centre, 1275 York Ave, New York, NY 10065, USA
| | - John H Healey
- Department of Orthopaedic Surgery, Orthopaedic Surgical Oncology, Memorial Sloan Kettering Cancer Centre, 1275 York Ave, New York, NY 10065, USA
| | - Francis J Hornicek
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital - Harvard Medical School, Room 3.946, Yawkey Building, 55 Fruit St, Boston, MA 02114, USA
| | - Joseph H Schwab
- Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital - Harvard Medical School, Room 3.946, Yawkey Building, 55 Fruit St, Boston, MA 02114, USA
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Yu TH, Tung YC, Wei CJ. Can Hospital Competition Really Affect Hospital Behavior or Not? An Empirical Study of Different Competition Measures Comparison in Taiwan. Inquiry 2017; 54:46958017690289. [PMID: 28147887 PMCID: PMC5798673 DOI: 10.1177/0046958017690289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Different approaches to measure the hospital competition index might lead to inconsistent results of the effects of hospital competition on innovation adoption. The purpose of this study is to adopt a different approach to define market area and measure the level of competition to examine whether hospital competition has a positive effect on hospital behavior, taking quality indicator projects participation as an example. A total of 238 hospitals located in Taipei, Taichung, and Kaohsiung were recruited in this study. Competition index was used as the independent variable, and participation lists of Taiwan Clinical Performance Indicator and Taiwan Healthcare Indicator Series in 2012 were used as dependent variables. All data used in this study were retrieved from the 2012 national hospital profiles and the participation list of the 2 quality indicator projects in 2012; these profiles are issued by the Taiwan Ministry of Health and Welfare annually. Geopolitical boundaries and 4 kinds of fixed radiuses were used to define market area. Herfindahl-Hirschman Index and hospital density were used to measure the level of competition. A total of 12 competition indices were produced in this study by employing the geographic information system, while max-rescaled R2 was used to evaluate and compare the models on goodness of fit. The results show that the effects of hospital competition on quality indicator projects participation were varied, which mean different indicators for market competition might reveal different conclusions. Furthermore, this study also found the Herfindahl-Hirschman Index at 5-km radius was the optimum competition index.
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Affiliation(s)
- Tsung-Hsien Yu
- 1 National Taipei University of Nursing and Health Sciences, Taiwan
| | - Yu-Chi Tung
- 2 National Taiwan University, Taipei City, Taiwan
| | - Chung-Jen Wei
- 3 Fu Jen Catholic University, New Taipei City, Taiwan
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Chen LS, Wang YR. A conceptual framework for Taiwan's hospital clinical performance indicators. J Formos Med Assoc 2015; 114:381-3. [DOI: 10.1016/j.jfma.2015.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 01/26/2015] [Accepted: 01/29/2015] [Indexed: 10/23/2022] Open
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