The Use of Performance Measures in Health Care Systems

BACKGROUND In China, significant emphasis and investment in health care reform since 2009 has brought with it increasing scrutiny of its public hospitals. Calls for greater accountability in the quality of hospital care have led to increasing attention toward performance measurement and the development of hospital ratings. Despite such interest, there has yet to be a comprehensive analysis of what performance information is publicly available to understand the performance of hospitals in China. OBJECTIVE This study aims to review the publicly available performance information about hospitals in China to assess options for ranking hospital performance. METHODS A review was undertaken to identify performance measures based on publicly available data. Following several rounds of expert consultation regarding the utility of these measures, we clustered the available options into three key areas: research and development, academic reputation, and quality and safety. Following the identification and clustering of the available performance measures, we set out to translate these into a practical performance ranking system to assess variation in hospital performance. RESULTS A new hospital ranking system termed the China Hospital Development Index (CHDI) is thus presented. Furthermore, we used CHDI for ranking well-known tertiary hospitals in China. CONCLUSIONS Despite notable limitations, our assessment of available measures and the development of a new ranking system break new ground in understanding hospital performance in China. In doing so, CHDI has the potential to contribute to wider discussions and debates about assessing hospital performance across global health care systems.

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Rating Hospital Performance in China: Review of Publicly Available Measures and Development of a Ranking System

Journal of Medical Internet Research ◽

10.2196/17095 ◽

2021 ◽

Vol 23 (6) ◽

pp. e17095

Author(s):

Shengjie Dong ◽

Ross Millar ◽

Chenshu Shi ◽

Minye Dong ◽

Yuyin Xiao ◽

...

Keyword(s):

Health Care ◽

Performance Measures ◽

Health Care Systems ◽

Hospital Performance ◽

Public Hospitals ◽

Performance Information ◽

Ranking System ◽

Tertiary Hospitals ◽

Care Systems ◽

Hospital Development

Background In China, significant emphasis and investment in health care reform since 2009 has brought with it increasing scrutiny of its public hospitals. Calls for greater accountability in the quality of hospital care have led to increasing attention toward performance measurement and the development of hospital ratings. Despite such interest, there has yet to be a comprehensive analysis of what performance information is publicly available to understand the performance of hospitals in China. Objective This study aims to review the publicly available performance information about hospitals in China to assess options for ranking hospital performance. Methods A review was undertaken to identify performance measures based on publicly available data. Following several rounds of expert consultation regarding the utility of these measures, we clustered the available options into three key areas: research and development, academic reputation, and quality and safety. Following the identification and clustering of the available performance measures, we set out to translate these into a practical performance ranking system to assess variation in hospital performance. Results A new hospital ranking system termed the China Hospital Development Index (CHDI) is thus presented. Furthermore, we used CHDI for ranking well-known tertiary hospitals in China. Conclusions Despite notable limitations, our assessment of available measures and the development of a new ranking system break new ground in understanding hospital performance in China. In doing so, CHDI has the potential to contribute to wider discussions and debates about assessing hospital performance across global health care systems.

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From “Don't Ask, Just Trust” to “Trust Those Who are Accountable”

Decision Management ◽

10.4018/978-1-5225-1837-2.ch040 ◽

2017 ◽

pp. 924-938

Author(s):

Vahé A. Kazandjian

Keyword(s):

Health Care ◽

Quality Of Care ◽

Performance Measurement ◽

Performance Measures ◽

Health Care Systems ◽

Measurement Tools ◽

Care Systems ◽

Key Dimensions ◽

Local Traditions

The past three decades have primarily focused on improving performance across health care providing organizations and even individual professionals. While their interest in performance improvement is global, the strategies across health care systems remain variable and the resulting methods of accountability to select audiences continue to be influenced by tradition and expectation. The purpose of this article is to review the key dimensions of the operationalization of performance measurement and the translation of its findings to statements about quality of care. While significant literature exists on the conceptual debates about the nature of quality, the deciding factor in demonstrating that better quality may have been achieved resides in the acceptability of the measurement tools to translate performance measures into profiles of quality. Fundamentally, the use of the tools is seen as only one component of a successful strategy – the education of various audiences as to what the measures mean not only is a necessary requisite for sound project design but also will determine how the accountability model is shaped in each environment based on the generic measurement tools results, local traditions of care and caring, and expectations about outcomes.

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