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Assessing the Relationships Between Hospital Resources and Activities: A Systematic Review

  • Systems-Level Quality Improvement
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Abstract

Hospitals face the challenge of minimizing their resource utilization without reducing the quality of healthcare. Achieving this aim requires precise analysis and optimization of various inputs and outputs. This paper presents a systematic review of the relationships between hospital resources (considered productivity inputs) and financial and activity outcomes (considered productivity outputs). Several electronic bibliographic databases and the Internet were searched for articles published between January 1990 and December 2013 that examined the relationships between hospital resources and financial and activity outcomes. We assessed the quality of the study design, the nature of the sample, input and output indicators, and the statistical methods used for each selected study. Thirty-eight original papers were selected. Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA) were the most statistical methods used. Based on our analysis, we retained 18 input and 19 output indicators that could constitute the basis for hospital productivity benchmarking. Selecting a small set of shared economic and activity indicators is relevant for assessing the productivity of a hospital, measuring trends and performing national or international benchmarking. Such indicators should be combined with quality measures for a comprehensive evaluation approach.

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Acknowledgment

We would like to thank Sophie Guiquerro, head of the Georges Pompidou Hospital Documentation Center, for her help to collect publications relevant to our subject, as well as Pr. Joel Menard from Paris Descartes University and Abdelali Boussadi from the Georges Pompidou University Hospital for their helpful comments on the different versions of the paper.

Authors contribution

BH made a substantial contribution to the conception and design of this study, acquisition, analysis and interpretation of results, and drafting of the article. RM, SM and SE made substantial contributions to the acquisition, analysis and interpretation of results, and critically revising the article. PD as PhD mentor of BH, made substantial contributions to framing the research objectives, analysis and interpretation of data, and critically revising the article.

Conflicts of interest

Brahim Hadji first author of the article, and on behalf of other authors declare that there is no conflict of interest in the present paper.

Author information

Authors and Affiliations

  1. Inserm-UMRS 1138, Cordelier Research Center, Team 22, Paris, France

    Brahim Hadji, Samir Melikeche & Patrice Degoulet

  2. Pierre and Marie Curie University, Paris, France

    Brahim Hadji

  3. University Hospitals of Geneva, Geneva, Switzerland

    Rodolphe Meyer

  4. Paris Descartes University, Paris, France

    Patrice Degoulet

  5. Georges Pompidou European Hospital, Paris, France

    Sylvie Escalon & Patrice Degoulet

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  1. Brahim Hadji
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  2. Rodolphe Meyer
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Correspondence to Brahim Hadji.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

Appendix

Appendix

Table 3 Validity evaluation
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Table 4 Description of the 36 selected articles
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Table 5 Explanatory model confirmation
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Fig. 4
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Productivity analysis framework

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Hadji, B., Meyer, R., Melikeche, S. et al. Assessing the Relationships Between Hospital Resources and Activities: A Systematic Review. J Med Syst 38, 127 (2014). https://doi.org/10.1007/s10916-014-0127-9

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  • DOI: https://doi.org/10.1007/s10916-014-0127-9

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