Indicators for hospital planning management. revision, analysis and proposals

Abstract

Institutions delivering medical care services have had to take upon themselves a continuous and permanent position of adapting to changes, be it toward their users, toward technological changes and variations in clinical practice, as well as to their own financial sustenance. In consequence, decision making has become complex with the increase in the quantity, variety and types of results of health interventions. At the same time, an infinite  volume of measuring of resources, processes, results and impact of such actions has been created, without the existence, at present, of an absolute agreement regarding the usefulness, validity or reliability of these measurings. A conceptual revision of health characteristics and indicators (both bibliographic and through interviews), a bibliographic investigation of national and international experiences, and a discussion and definition of dimensions of planning management indicators for the Davila Clinic, were carried out in the framework of its working plan for the year 2003. Five dimensions for: technical quality, effectiveness, efficiency, insurance relations and user relations, were defined. For each one of these, the revision of experiences showed a distribution of indicators of 58.6%. 9. 7%, 45.2%, 3.2%, and 22.6% respectively, while the local analysis presented a distribution of 37.4%, 0.0%, 17.14%, 22.9%, and 22.9% respectively, which resulted to be concordant with the greater prevalence of technical quality indicators. On the other hand, local indicators of user and insurance relations stand out, dimensions which were only slightly approached or not approached in other experiences. Finally, suggestions for a working proposal in this setting, to be developed within the institution, are being given close attention.