An inter-hospital performance assessment model for evaluating hospitals performing hip arthroplasty

• Published in: Healthcare analytics (New York, N.Y.) Vol. 6; p. 100365
• Main Authors: Dehanne, Fabian, Pirson, Magali, Cuvelier, Etienne, Bielen, Frédéric, Leclercq, Pol, Libert, Benoît, Gourdin, Maximilien
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-12-2024; Elsevier
• Subjects: Disability adjusted life years; Healthcare cost; Hospital ranking; Inter-hospital evaluation; Patient satisfaction; Performance assessment; Hospital ranking; Patient satisfaction; Inter-hospital evaluation; Performance assessment; Disability adjusted life years; Healthcare cost
• ISSN: 2772-4425; 2772-4425
• DOI: 10.1016/j.health.2024.100365

The value of hospital care to patients is expressed as a combination of reduced healthcare costs, fewer medical complications, and improved patient satisfaction. Few studies highlight the value hospitals provide to their patients through hip replacement surgery.
This study aims to define a methodology for inter-hospital comparison purposes that can assess the value of hip replacement management to patients by using indicators of costs, medical complications, and patient outcomes.
We identified medical complications and costs from medico-administrative data collected by three hospitals. We associated a Disability Adjusted Life Years (DALYs) impact with medical complications, readmissions (within 30 days), and hospital mortality. Costs were analysed from a social security perspective. Patient outcomes were collected through a questionnaire-based survey after hip surgery. To compare the three hospitals, we created a composite indicator by standardizing each dependent variable and combining a weighting of importance provided by patients.
This study analysed 342 hospital stays. The mean (standard deviation) number of DALYs per stay was estimated to be more than 0.0028 (0.016) for a mean (standard deviation) cost of €4,834 (€3,665). The composite indicator allowed hospitals to be ranked and areas for improvement to be identified. In our case mix, Hospital 3 is the lowest-ranked hospital, with excessively high costs and a relatively low level of satisfaction compared to the others.
The simultaneous evaluation of medical complications, patient outcomes, and costs is a prerequisite for quality improvement efforts by managers and practitioners. In our opinion, this experiment, which sought to estimate the value hospitals bring to patients, may be viewed as the first step towards value-based purchasing in Belgium.
•Develop an inter-hospital performance assessment model for hospital evaluation.•Evaluate the overall management of hip replacements using three complementary indicators.•Suggest a composite indicator to assess the value of patient care.•Propose a method for practitioners to implement concrete actions to improve hospital performance.