An Approach Toward Public Hospital Performance Assessment

BACKGROUND:The patients' health care choice is diverting from the private health provider to the public hospital due to introduction of various schemes and incentives by the policy makers. The limited resources are posing a challenge to the hospital administrator in escalating demands, diversity and complexity of diseases of patients. The hospital performance enhances steadily by the monitoring authorities' surveillance. It is an effective method for improving quality care in the public hospital. The Hawthorne effect is a term referring to the tendency of people to work harder and increases in effectiveness of organization when they are being observed. OBJECTIVES: 1. To assess the performance of a teaching hospital during surveillance by calculating the hospital indices, using the Pabon Losso Model. 2. To evaluate whether the Hawthorne effect is the cause of the increase in the effectiveness of hospital. MATERIALS AND METHODS: The study was a prospective and record based cross-sectional study and conducted at Government teaching hospital over a period of 18 months. RESULTS: st A total of 18 months period census report was recorded from January 2016 to June 2017and hospital indices were estimated. The 1 phase of surveillance (January- 2016 to May -2016), where immense supervision was present, with performance feed- back, BOR was 88.65, nd ALOS was 3.932, BTR was 7.074 and BTI was 0.54, 2 phase of surveillance which was intensied with communication and committee meetings rd (June-2016 to October- 2016), BOR was 95.59, ALOS was 3.49, BTR was 7.03 and BTI was 0.886, 3 phase weaning period, where a little th supervision (November -2016 to February-2017) BOR was 87.8, ALOS was 4.1, BTR was 6.413 and BTI was 0.5725 and 4 phase self sustain stage or no observations phase, BOR was 92.6, ALOS was 3.47, BTR was 6.547 and BTI was 0.28. CONCLUSION: The surveillance of higher authorities over the hospital had increased the performance. Hospital efciency is reected by increased hospital indices. The cause and effect is the “Hawthorne effect”. Therefore it is concluded that the surveillance increases the performance and efciency of the public hospitals.

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PUBLIC HOSPITAL PERFORMANCE MANAGEMENT: A QUESTIONNAIRE DESIGN

DOKBAT 2019 - 15th International Bata Conference for Ph.D. Students and Young Researchers ◽

10.7441/dokbat.2019.058 ◽

2019 ◽

Author(s):

Josef Krupička

Keyword(s):

Performance Management ◽

Public Hospital ◽

Hospital Performance ◽

Questionnaire Design

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An assessment for Public Hospitals Associations' performance measurement approachKamu Hastaneleri Birlikleri performans ölçüm yöntemi üzerine bir değerlendirme

Journal of Human Sciences ◽

10.14687/ijhs.v13i1.3601 ◽

2016 ◽

Vol 13 (1) ◽

pp. 695 ◽

Cited By ~ 3

Author(s):

Emre Atılgan

Keyword(s):

Performance Measurement ◽

Performance Assessment ◽

Production Efficiency ◽

Hospital Performance ◽

Public Hospitals ◽

Management Approach ◽

Managerial Performance ◽

Frontier Analysis ◽

The Public ◽

Measurement Approach

Health Transformation Program (HTP) was launched in 2003 with the primary aim of achieving effectiveness, efficiency, and equity in organization, delivery, and financing of health care services in Turkey. In the final leg of the program, the Public Hospital Associations (PHA), which are basically the regional hospital unions, were announced in 2011 with the legislative decree no.663 and have been in operation since fall 2012. Establishment of the PHAs introduced a new management approach for Turkish public hospitals. This model based on a new managerial performance assessment approach, which was developed to evaluate the hospitals’ performances in many dimension, including medical, administrative, financial, quality, patient safety, employee-satisfaction and education aspects. In this regard, the Turkish Public Hospitals Institution (PHI), which is the highest institution that rules all the public hospitals, has begun to use modified version of Balanced Score Card (BSC) approach to assess the managerial performance of the PHAs. In this approach, production efficiency scores of hospitals, which are estimated with Stochastic Frontier Analysis (SFA), became a key or a target indicator for hospital performance assessment. In this paper, the performance measurement approach of the PHAs is assessed with respect to the theoretical methods used in this approach, i.e. BSC and SFA efficiency methods. ÖzetSağlıkta Dönüşüm Programı (SDP), Türkiye’de sağlık hizmetlerinin organizasyon, sunum ve finansmanında etkililik, etkinlik ve hakkaniyet sağlamak amacıyla 2003 yılında uygulamaya konulmuştur. Programın son ayağında, basit anlamda hastanelerin yönetimsel olarak birleşmesi ifade eden Kamu Hastaneleri Birlikleri (KHB), 2011 yılında 663 nolu KHK ile kurulmuş ve 2012 yılında faaliyete başlamıştır. KHB’lerin kurulmasıyla birlikte Türkiye kamu hastaneleri için yeni bir yönetim yaklaşımı oluşturulmuştur. Bu yaklaşım, hastanelerin performansını, tıbbi, idari, mali, kalite, hasta ve Çalışan güvenliği-memnuniyeti ile eğitim boyutlarında değerlendirilmesini amacıyla geliştirilmiş olan yönetimsel performans modeli üzerine kurulmuştur. Uygulamaya konulan yeni sistemde, kamu hastanelerinin yönetici kuruluşu olan Türkiye Kamu Hastaneleri Kurumu (TKHK), KHB’lerin yönetimsel performansının değerlendirilmesi için, Dengeli Skor Kartı (DSK) yaklaşımının uyarlanmış bir şeklini kullanmaya başlamıştır. Bu yaklaşımda, Stokastik Sınır Analizi yöntemiyle hesaplanan hastane üretim etkinlik skorları, hastane performansının belirlenmesinde anahtar ya da hedef gösterge olmuştur. Bu çalışmada Kamu Hastaneleri Birlikleri performans değerlendirme modelinin, modelin kullandığı DSK ve SSA yöntemleri çerçevesinde bir değerlendirmesi sunulmaktadır.

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