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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]