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A national multi-dimensional conceptual framework for comparative evaluation of hospital performance linking and balancing the needs and expectations of relevant stakeholders

Kineret Oren1, Avishay Goldberg, PhD1, Ahuva Meilik-Weiss, PhD2, and Joseph S. Pliskin, PhD1. (1) Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, 84105, Israel, 972-8-6477417, Kinoren@bgu.ac.il, (2) Department of Clinical & Economic Performance, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, 52621, Israel

Background: Providing high quality healthcare to diverse populations within tight financial constraints is a major challenge. Meeting it requires development of national tools for assessing healthcare providers' performance, especially hospitals, as they are responsible for the most complex and intensive parts of the system and a substantial share of its overall budget. This, together with known gaps in hospital performance and the high cost of quality problems, emphasize the importance of developing strategies for improving hospital performance. Objective: To design a conceptual framework for comparative performance evaluation of Israel's public general hospitals linking and balancing the needs and expectations of four stakeholders the Ministry of Health, hospitals, HMOs and consumers. Methodology: Qualitative research based on an extensive literature review, in-depth semi-structured interviews and a modified Delphi process. Findings: A multi-dimensional framework is proposed, including: definition of key concepts and dimensions of hospital performance and their interrelations; design of an architecture to enhance evidence-based management and quality improvement; definition of criteria for performance indicators and their selection; identification of trade-offs between components; strategies for framework implementation. Conclusions: The framework proposed will advance high quality care, taking into account financial constraints and consumer satisfaction. Its focus is not merely on communicating accurate information, but on understanding how to present and target it so it is actually used in the user's decision-making process. It supports informed decisions and advances effectiveness, efficiency and equity through responsiveness to stakeholder segments, integration of performance dimensions, focus on a minimal number of critical measures and balance.

Learning Objectives:

Keywords: Hospitals, Performance Measures

Presenting author's disclosure statement:

Any relevant financial relationships? No

Advances in Organizational Design and Management

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA