190343 Developing a national framework for comparative performance evaluation of public general hospitals: Integrating clinical, financial and service-oriented dimensions of evaluation

Monday, October 27, 2008

Kineret Oren, MBA , Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Avishay Goldberg, PhD , Health System Management, Ben Gurion University, Beer Sheva, Israel
Joseph S. Pliskin, PhD , Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Background: In an era in which healthcare systems are characterized by limited resources and increasing complexity, policymakers are looking for tools to evaluate and improve quality, which will assure the public of maximal quality within existing resources.

Objective: To design a national framework for comparative performance evaluation of Israel's public general hospitals (PGHs), fully integrating clinical, financial and service-oriented dimensions.

Methodology: Qualitative research based on an extensive literature review and in-depth semi-structured interviews.

Results: A multidimensional framework is proposed. The basic unit for comparison across hospitals was defined as a medical procedure or diagnosis. Accordingly, the evaluation of each of Israel's PGHs is based on an agreed, limited fixed set of key medical procedures and diagnoses in each of its main contexts (pediatrics, surgery, internal medicine, and women's health). Each medical procedure or diagnosis is simultaneously evaluated by a set of indicators in three agreed core perspectives, clinical, financial, and consumer-oriented, enabling full integration throughout the framework. A system for determining weights for each dimension reflecting key stakeholders' and professionals' points of view was designed.

Conclusions: The proposed framework will assure maximal integration between perspectives by linking all evaluation dimensions to the same core unit, consequently making it possible to assess how a change in one dimension impacts others. This infrastructure supports attaining optimization among perspectives by achieving the best balance between them. The multidimensional architecture enables policymakers to contend with the need to improve the quality of medical care and patient satisfaction within budgetary constraints.

Learning Objectives:
1. Identify tradeoffs between clinical, financial and service-oriented dimensions of evaluation. 2. Recognize the importance of integrating clinical, financial and service-oriented dimensions in evaluating healthcare organizationsí performance.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student in the department Health Systems Management at Ben-Gurion University of the Negev and I conducted the research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.