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Do relationships exist between the scope and intensity of quality improvement activities and hospital operation performance? A 10-year observation in Taiwan.

Chung KP, Yu TH - BMC Health Serv Res (2015)

Bottom Line: The results showed a significant increase in the scope and intensity of QI activities between 2000 and 2009.The results also showed that the scope and intensity of a hospital's QI activities were associated with the scope and intensity of its competitors' QI activities in the previous period and its own prior performance.Furthermore, some performance measures are associated with the intensity of the QI activities in the previous period.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health Policy and Management, National Taiwan University, Room 643, No 17, Suchow Road, Taipei, Taiwan. kpchung@ntu.edu.tw.

ABSTRACT

Background: The relationship between the scope and intensity of quality improvement (QI) activities and hospital performance remains unclear. This study investigated the relationship between performance, external environment, and the scope and intensity of QI activities in hospitals.

Methods: The study used a longitudinal observation. Data regarding the scope and intensity of QI activities were collected using a questionnaire survey among the administrative deputy superintendents / directors of quality management center in 139 hospitals. Hospital performance indicators were abstracted from the 2000-2009 national hospitals profiles. We adopted year 2000 as the baseline, and divided the study period into three 3-year periods. The Generalized Estimating Equations (GEE) model was used for the statistical analysis.

Results: Seventy-two hospitals responded to the survey, giving a response rate of 52%. The results showed a significant increase in the scope and intensity of QI activities between 2000 and 2009. The results also showed that the scope and intensity of a hospital's QI activities were associated with the scope and intensity of its competitors' QI activities in the previous period and its own prior performance. The scope of QI activities in the previous period was not significantly related to the selected hospital performance measures. However, the intensity of QI activities in the previous period showed a significant and positive relationship with the number of inpatients and the turnover of beds.

Conclusion: The study demonstrates that the intensity of QI activities is associated with the external environment and the hospital's own performance in the previous period. Furthermore, some performance measures are associated with the intensity of the QI activities in the previous period.

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Related in: MedlinePlus

Conceptual framework for purpose 1
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Fig1: Conceptual framework for purpose 1

Mentions: For question 1, hospitals’ performance in the previous period and the scope and intensity of QI activities of competitors within the same service area in the previous period were used as independent variables, and the scope and intensity of QI activities in the current period were used as the dependent variables. In this study, we used 17 medical areas as defined by the Taiwan Ministry of Health and Welfare to define each hospital’s service area. These 17 medical areas correspond to 17 geopolitical areas of Taiwan, and the approach to define service areas is similar to that for the health service areas adopted in the United States. The conceptual framework of this part is demonstrated in Fig. 1. For question 2, hospitals’ scope and intensity of QI activities in the previous period was used as the independent variable, and current-period performance was the dependent variable. The conceptual framework of this part is demonstrated in Fig. 2.Fig. 1


Do relationships exist between the scope and intensity of quality improvement activities and hospital operation performance? A 10-year observation in Taiwan.

Chung KP, Yu TH - BMC Health Serv Res (2015)

Conceptual framework for purpose 1
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4536734&req=5

Fig1: Conceptual framework for purpose 1
Mentions: For question 1, hospitals’ performance in the previous period and the scope and intensity of QI activities of competitors within the same service area in the previous period were used as independent variables, and the scope and intensity of QI activities in the current period were used as the dependent variables. In this study, we used 17 medical areas as defined by the Taiwan Ministry of Health and Welfare to define each hospital’s service area. These 17 medical areas correspond to 17 geopolitical areas of Taiwan, and the approach to define service areas is similar to that for the health service areas adopted in the United States. The conceptual framework of this part is demonstrated in Fig. 1. For question 2, hospitals’ scope and intensity of QI activities in the previous period was used as the independent variable, and current-period performance was the dependent variable. The conceptual framework of this part is demonstrated in Fig. 2.Fig. 1

Bottom Line: The results showed a significant increase in the scope and intensity of QI activities between 2000 and 2009.The results also showed that the scope and intensity of a hospital's QI activities were associated with the scope and intensity of its competitors' QI activities in the previous period and its own prior performance.Furthermore, some performance measures are associated with the intensity of the QI activities in the previous period.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health Policy and Management, National Taiwan University, Room 643, No 17, Suchow Road, Taipei, Taiwan. kpchung@ntu.edu.tw.

ABSTRACT

Background: The relationship between the scope and intensity of quality improvement (QI) activities and hospital performance remains unclear. This study investigated the relationship between performance, external environment, and the scope and intensity of QI activities in hospitals.

Methods: The study used a longitudinal observation. Data regarding the scope and intensity of QI activities were collected using a questionnaire survey among the administrative deputy superintendents / directors of quality management center in 139 hospitals. Hospital performance indicators were abstracted from the 2000-2009 national hospitals profiles. We adopted year 2000 as the baseline, and divided the study period into three 3-year periods. The Generalized Estimating Equations (GEE) model was used for the statistical analysis.

Results: Seventy-two hospitals responded to the survey, giving a response rate of 52%. The results showed a significant increase in the scope and intensity of QI activities between 2000 and 2009. The results also showed that the scope and intensity of a hospital's QI activities were associated with the scope and intensity of its competitors' QI activities in the previous period and its own prior performance. The scope of QI activities in the previous period was not significantly related to the selected hospital performance measures. However, the intensity of QI activities in the previous period showed a significant and positive relationship with the number of inpatients and the turnover of beds.

Conclusion: The study demonstrates that the intensity of QI activities is associated with the external environment and the hospital's own performance in the previous period. Furthermore, some performance measures are associated with the intensity of the QI activities in the previous period.

Show MeSH
Related in: MedlinePlus