Abstract
BackgroundIn 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.ObjectiveThis study aims to review the publicly available performance information about hospitals in China to assess options for ranking hospital performance.MethodsA 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.ResultsA 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.ConclusionsDespite 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.
Highlights
Hospital rating systems have the potential to play an important role in patient decision-making as well as offer policy makers and practitioners valuable opportunities to monitor and improve the quality of hospital services [1,2,3,4]
principal component analysis (PCA) Results Table 4 shows the results of the analysis, including the number of original indicators, number of selected indicators, number of principal components (PCs) retained, and accumulation of variance for each domain
PC1 is highly correlated with the medical malpractice claims measures, whereas PC2 is highly correlated with the quality of specialty care measures
Summary
Hospital rating systems have the potential to play an important role in patient decision-making as well as offer policy makers and practitioners valuable opportunities to monitor and improve the quality of hospital services [1,2,3,4]. An enduring feature of China’s health care provision is the dominance of the hospital sector Within these contexts, patients are offered different forms of provision ranging from grade I community hospitals, grade II secondary or county hospitals serving several communities, and grade III tertiary hospitals serving districts or cities. 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. CHDI has the potential to contribute to wider discussions and debates about assessing hospital performance across global health care systems
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