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Table 2 Taxonomy of hospital performance indicators

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

Theme

Sub-theme

Indicators

References

Efficiency/utilization (17 of the 49 included study)

Number of human resources

Number of physicians

Number of nurses,

Number of clinical personnel,

Number of full-time equivalent interns/residents

Number of administrative personnel,

Number of nonclinical personnel,

FTE/adjusted admissions

[20, 22,23,24, 45, 51, 52, 79, 80]

Number of hospital beds

Percentage of specialized beds (%),

Percentage of other beds

The ratio of active beds to fixed beds

[25, 46, 70, 79, 80]

Cost

Cost of medical/operating supplies

Wage and salary payments to personnel engaged in patient/non-patient care

Capital costs, i.e. building and land;

Adjusted depreciation charges for fixed and movable equipment;

Cost/adjusted admission

Cost of inpatient services per patient day (cost per in-patient)

[22, 45, 47, 48, 50, 79]

OR utilization

Number of OR cases booked

Number of OR cases performed

Number of OR cases cancelled

Percentage of OR cancellations

Percentage of surgical operations to surgery beds

Day stay surgery rate

[19, 24, 26, 30]

ER utilization

Total number of ER visits

ER treatment time

[22, 30, 48]

ICU utilization

Average ICU bed Occupancy rate

Average ICU length of stay

[30, 48]

Technology utilization

Use of electronic medical records,

Rate of utilization of existing technology

Number of high-tech services

Number of medical supplies per bed

Number of other operating supplies per bed

Clinical integration (binary)

Integrated data base

[20, 22]

Radiology utilization

Total radiological procedures

[30]

Laboratory utilization

Total lab investigations

[30]

Other

Bed occupancy rate

Average length of stay

Bed turnover interval

Monthly number of inpatients

Monthly number of outpatients

Average number of drugs per encounter

[19, 20, 22,23,24,25, 27, 29, 30, 46,47,48, 51, 53, 62, 66, 79, 80]

Financial (15 of the 49 included study)

Profit

Total marginal profit

Medical benefit–cost–per FTE

[19, 81, 82]

Revenue

Operating revenue per adjusted patient days

Non-operating revenue

Current ratio, n (%) = the ratio of net income (revenues/expenses) to total revenues

Revenue per physician FTE

[19, 47, 51, 62]

Cash flow

Cash to total debt

[47, 82, 83]

Cost

Operating costs per adjusted patient days

Unit Cost Performance,

N (%) Cost of outpatient visits (primary vs. secondary cases)

Cost of salaries and overtime (clinical vs. non-clinical staff)

Emergency services expenses

Personnel expenses

Goods and services expenses

Medicine expenses

Average cost per day of hospitalization

Pharmacy cost

[19, 62, 84]

Investment

Return on investment

[27]

Asset

Total asset turnover

Tangible assets

Return on assets

[27, 70, 82]

Debt

Total debt/total assets

Long-term debt to capitalization

Debt ratio

[27, 47, 70]

Liquidity

Current ratio

Days revenue in net accounts receivable

Days cash on hand

Average payment period

Replacement viability

Acid test ratio

Quick ratio

Budget flow compared to approved budget

[27, 70]

Effectiveness (20 of the 49 included study)

Accessibility (equity)

Waiting time in emergency room

Waiting time for initial clinical examination at the ER after arrival

Waiting time for admission after arrival at the ER

Waiting time for selective surgical treatment

Patients leaving without being examined

Outpatient appointment waiting lists

Overall satisfaction rate of patient with nursing care

Adherence rate to the patient satisfaction survey

Outcome and satisfaction of complaints

Communication/information

Caring/compassion

Ease of access

Parking/food/other services

Control of pain or other symptoms

Expected results achieved

Coordination of care

Involvement of family and friends

Respect for values and preferences

Amenities

Comprehensiveness

Continuity

[19, 20, 29, 30, 52, 64, 65]

Safety

Rate of nosocomial infections

Rate of accidents

Rate of complications

Failure to rescue

Incidents/near misses

Accidents/adverse events

Needle stick events

Hospital-acquired infections

Medical errors per sector

Staff injury

Staff needle puncture incidents

Ventilator pneumonia

Technical difficulty with procedure

Medical equipment-related adverse event

Patient falls

Wrong surgery rate (wrong side, wrong body part, or wrong person)

Hand hygiene compliance rate

Postoperative respiratory failure

Postoperative sepsis

Prevalence of sentinel events

[19, 22, 30, 47, 48, 52, 53, 64, 66,67,68]

Quality

Unplanned readmissions

30-day mortality

Perioperative mortality

Cancer patients successfully surviving surgery/chemotherapy/transplant

The pure rate of hospital mortality,

Success to hospitals in obtaining certificates of management quality

Appropriateness of care (caesarean section rate)

Surgery postponed or canceled

Management team participation in Quality Improvement (QI) programs (Board activity in QI, CEO participation in QI activities, Board monitoring of QI, Clinic audit meetings held, Perceived barriers to QI)

Diffusion of QI across hospital units

Proportion of FTEs on QI teams

Proportion of physicians on QI teams

Management of hospital waste

Number of guidelines developed

Proportion of physicians using guidelines

Staffing level and training hours (for staff with direct patient contact)

A patient safety committee

A system for reviewing patient deaths

Policies for handling dangerous chemicals

A credentialing committee

Quality of life used to assess organizational performance

Technical quality of care

Appearance of facilities

[19, 20, 26, 29, 47, 48, 52, 53, 64, 65, 68, 69]

Responsiveness

Patient centeredness

Patient feedback management

Pain control

Satisfaction from personnel

Explanation of procedures

treatment and discharge

information

Satisfaction from hospital environment

Staff orientation

Staff burnout

Staff absenteeism

Staff working overtime

Satisfaction from working environment

Clearly defined responsibilities in staff

average payment

Diversity

Working hours

Frequency of night duty/shift

Occupied position

Average experience in current dept.

Staff safety

Number of work-related injuries

Paid leave

Number of staff per bed

Continuous education for health professionals

Number training hours on total number of working hours

Training budget on total budget dedicated to staff

Vacancy

Social responsibility

Leadership and inner processes which include the areas of mission and vision, policies and procedures, ethical codes, regulations and procedures

Marketing that refers to suppliers and contractors, supply chain, consumer rights, responsibilities and liability management services including responsible purchasing

Workplace environment which contains staff safety and health issues

An environment which includes issues of sustainable development, pollution, waste management, energy saving and green purchasing management

Community that states the local community, academic community in partnership with social institutions, partnership with non-governmental organizations (NGOs), volunteer participation supporting activities of employee and charitable support

Provider mix reflective of community(ies) served

Governing board and management staff reflective of community(ies) served Community Benefit

Care provided in public programs (e.g., Medicaid)

Numbers served in free clinical service programs (e.g., blood pressure screening, immunizations)

[19, 20, 29, 30, 47, 48, 52, 53, 64,65,66,67, 69, 70]