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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
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
[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
Satisfaction from hospital environment
Staff orientation
Staff burnout
Staff absenteeism
Staff working overtime
Satisfaction from working environment
Clearly defined responsibilities in staff
average payment
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
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]