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Performance evaluation of hospitals that provide care in the public health system, Brazil

OBJECTIVE: To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS: This cross-sectional study evaluated data from the Hospital Information System an...

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Autores principales: Ramos, Marcelo Cristiano de Azevedo, da Cruz, Lucila Pedroso, Kishima, Vanessa Chaer, Pollara, Wilson Modesto, de Lira, Antônio Carlos Onofre, Couttolenc, Bernard François
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Saúde Pública da Universidade de São Paulo 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544687/
https://www.ncbi.nlm.nih.gov/pubmed/26247385
http://dx.doi.org/10.1590/S0034-8910.2015049005748
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author Ramos, Marcelo Cristiano de Azevedo
da Cruz, Lucila Pedroso
Kishima, Vanessa Chaer
Pollara, Wilson Modesto
de Lira, Antônio Carlos Onofre
Couttolenc, Bernard François
author_facet Ramos, Marcelo Cristiano de Azevedo
da Cruz, Lucila Pedroso
Kishima, Vanessa Chaer
Pollara, Wilson Modesto
de Lira, Antônio Carlos Onofre
Couttolenc, Bernard François
author_sort Ramos, Marcelo Cristiano de Azevedo
collection PubMed
description OBJECTIVE: To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS: This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimento s de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS: The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS: The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.
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spelling pubmed-45446872015-08-31 Performance evaluation of hospitals that provide care in the public health system, Brazil Ramos, Marcelo Cristiano de Azevedo da Cruz, Lucila Pedroso Kishima, Vanessa Chaer Pollara, Wilson Modesto de Lira, Antônio Carlos Onofre Couttolenc, Bernard François Rev Saude Publica Original Articles OBJECTIVE: To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS: This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimento s de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS: The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS: The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals. Faculdade de Saúde Pública da Universidade de São Paulo 2015-07-27 /pmc/articles/PMC4544687/ /pubmed/26247385 http://dx.doi.org/10.1590/S0034-8910.2015049005748 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Ramos, Marcelo Cristiano de Azevedo
da Cruz, Lucila Pedroso
Kishima, Vanessa Chaer
Pollara, Wilson Modesto
de Lira, Antônio Carlos Onofre
Couttolenc, Bernard François
Performance evaluation of hospitals that provide care in the public health system, Brazil
title Performance evaluation of hospitals that provide care in the public health system, Brazil
title_full Performance evaluation of hospitals that provide care in the public health system, Brazil
title_fullStr Performance evaluation of hospitals that provide care in the public health system, Brazil
title_full_unstemmed Performance evaluation of hospitals that provide care in the public health system, Brazil
title_short Performance evaluation of hospitals that provide care in the public health system, Brazil
title_sort performance evaluation of hospitals that provide care in the public health system, brazil
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544687/
https://www.ncbi.nlm.nih.gov/pubmed/26247385
http://dx.doi.org/10.1590/S0034-8910.2015049005748
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