A. CHRISTODOULAKIS¹, H. KARANIKAS², A. BILLIRIS¹, E. THIREOS³, N. PELEKIS<sup>4

1</sup> Datamed S.A., Athens, Greece
² National & Kapodistrian University of Athens, Greece
³ Athens Medical Society, Greece
⁴ University of Piraeus, Department of Statistics and Insurance Science, Greece
 

Abstract

Objective: To examine how common Key Performance Indicators (KPIs) change when hospitals' clinical workload indicators, based on Diagnosis-Related Group (DRG) data, are incorporated in the measurement. From a data and knowledge management point of view the data evidently fulfills all four ‘V’ challenges (Volume, Velocity, Variety, Veracity) and the ‘D’ challenge (Distribution of data sources) that constitute the big data era.

Methods: This study includes annual detailed financial, operational and patient data, as recorded by the ESY.net web application, for 129 Greek NHS hospitals. Four Key Performance Indicators were calculated and examined based on financial and patient data of hospitals. The indicators are then adjusted to the case mix (i.e. clinical workload) of the units, with the help of a hospital clinical weight indicator, based on DRG data.

Results: The results of the study reveal that there were significant changes in the KPIs both in percentage and in the relative ranking of hospitals in efficient and inefficient. Hospitals with more severe than average incidents such as cancer hospitals, cardiac surgery centres, etc, but also some general hospitals and health centres, improved their indicators and their relative ranking. Small health centres and regional hospitals reported worse results after the adjustment of the indicators.

Conclusion: The study concludes that the significant changes in hospitals' ranking, that occurred after the KPIs were adjusted by the clinical workload of the units, render this tool inappropriate for decision makers (MoH) in the health care sector, when the diversity in hospitals' clinical workload is not taken into account, as they provide misleading information. The results of the study support the need for the re-evaluation of the performance of Greek NHS hospitals, in order to identify weaknesses of the system, improve efficiency and achieve potential improvements.


Key words: Key Performance Indicators, Clinical Workload Indicators, Health Big Data, Hospital Performance   

Short Title: Assessing Hospital Performance

 

“Archives of Hellenic Medicine, 2016”