Topic

Performance, productivity and quality

Measures of how well health services use their resources and how safe and effective their care is. Efficiency methods such as Data Envelopment Analysis and Stochastic Frontier Analysis sit beside operational measures such as Average Length of Stay and Occupancy Rate, and quality indicators such as Readmission Rate and the Standardised Mortality Ratio.

Concepts in this topic

• Administrative SimplificationAdministrative simplification is policy to cut the cost of health system paperwork, such as claims, eligibility checks and prior authorisation.
• Administrative WasteAdministrative waste is health care administrative spending that adds no value or costs more than needed, such as duplicate reporting or complex billing.
• Adverse Drug EventAn adverse drug event (ADE) is harm to a patient from a medicine, whether caused by a medication error or by a reaction despite correct use.
• Adverse EventAn adverse event (AE) is any unfavourable medical occurrence after treatment, caused by it or not; in patient safety, an injury caused by medical care.
• Adverse Event RateAdverse event rate (AE rate) is the count of adverse events, or of patients with one, divided by the patients or person-time at risk in a stated period.
• Antenatal Care CoverageAntenatal care coverage is the share of women with a recent live birth who had at least one, four or eight antenatal contacts; ANC4+ is a UHC tracer.
• Antibiotic StewardshipAntibiotic stewardship is a coordinated programme that improves antibiotic prescribing to protect patients, slow resistance and cut avoidable costs.
• Appropriate CareAppropriate care is care whose expected benefit exceeds its harms by a clear margin, avoiding overuse and underuse that reduce health system efficiency.
• Appropriateness CriteriaAppropriateness criteria are expert panel ratings of when a procedure's benefit exceeds its harms enough to be worth doing, exclusive of cost.
• Average Length of StayAverage length of stay (ALOS) is the mean number of days inpatients spend in hospital: total bed-days divided by discharges over the same period.
• Bed TurnoverBed turnover is the number of discharges, including deaths, per available hospital bed over a period, using the average number of beds available.
• BenchmarkingBenchmarking is the structured comparison of a health care provider's performance, costs or processes with peers or standards to adopt better practice.
• C. diff RateA measure of the frequency of healthcare-associated Clostridioides difficile infections within a facility, tracking infection prevention and stewardship performance.
• Capacity PlanningCapacity planning estimates the beds, staff, theatre time and equipment a health service needs to meet expected demand to a stated standard of access.
• Capacity UtilisationCapacity utilisation is the share of available health care capacity, such as staffed beds, theatre sessions or scanner time, that is used over a period.
• CAUTI RateA measure of the frequency of catheter-associated urinary tract infections within a facility, tracking infection prevention performance for catheter care.
• CLABSI RateA measure of the frequency of central line-associated bloodstream infections within a facility, tracking infection prevention performance for catheter care.
• Complaint RateA measure of how frequently patients or families formally express dissatisfaction with the care or service received within an organisation.
• Complication RateA measure of how frequently a specific adverse outcome occurs within a defined patient population undergoing a particular procedure.
• Data Envelopment AnalysisData envelopment analysis, or DEA, is a non-parametric linear-programming method that compares the relative technical efficiency of organisations or other decision-making units using multiple inputs and outputs.
• Demand ForecastingDemand forecasting projects future use of health services and medicines, and the staff needed, from past utilisation, population change and other drivers.
• Efficiency IndexAn efficiency index is a specified numerical measure that compares a unit’s resource use and valued output with a defined benchmark or estimated production frontier.
• Failure to RescueFailure to rescue is a serious adverse outcome, usually death, among patients who experience a defined potentially treatable complication, commonly measured as deaths divided by patients with qualifying complications.
• Falls RateFalls rate is inpatient falls per 1,000 occupied bed days (patient days), a hospital patient safety indicator also reported for injurious falls.
• Geometric Mean LOSA statistical measure of typical diagnosis-related group length of stay, using geometric rather than arithmetic mean to reduce outlier influence.
• Grievance RateA measure of how frequently patients or families file a formal grievance regarding their care, distinguished from a less formal complaint.
• Harm RateA harm rate is the frequency of a defined adverse outcome divided by the corresponding person-time at risk or exposure, with its meaning depending on whether first or recurrent events are counted.
• Health Worker DensityA measure of the number of healthcare workers, such as physicians or nurses, available relative to the population they serve.
• Healthcare AccreditationHealthcare accreditation is external review of health services against published standards by an accrediting body, with public recognition if they comply.
• Infection RateA measure of how frequently a specific type of infection occurs within a defined population and time period.
• Malmquist IndexA productivity measure decomposing efficiency change over time into genuine technical progress versus change relative to an evolving best-practice frontier.
• Medication Error RateA measure of how frequently mistakes occur in prescribing, dispensing, or administering medications within a healthcare organisation.
• MRSA RateA measure of the frequency of methicillin-resistant Staphylococcus aureus infections within a facility, an infection prevention and resistance indicator.
• Near Miss RateA near miss rate is the number of events meeting a specified near-miss definition relative to a matching population or set of opportunities during a stated period, expressed on an explicit scale.
• Net Promoter ScoreA customer loyalty metric based on likelihood to recommend, adapted in healthcare to measure patient satisfaction and provider recommendation likelihood.
• Observed-to-Expected RatioA measure comparing a provider's actual observed outcomes against statistically expected numbers given patient severity, above one meaning worse than expected.
• Occupancy RateOccupancy rate (bed occupancy) is the percentage of a hospital's available staffed beds that hold inpatients, averaged from daily bed counts over a period.
• Outcome MeasureA specified instrument, observation or data rule used to quantify a health, care or resource outcome for a defined population and time point.
• Pressure Ulcer RateA measure of how frequently hospitalised patients develop pressure ulcers, or bedsores, a nursing care quality and prevention indicator.
• Process CapabilityA statistical measure of how consistently a process produces output within specified acceptable limits, assessing whether it reliably meets targets.
• Quality of CareThe degree to which health services for individuals and populations increase the likelihood of desired health outcomes while remaining consistent with current professional knowledge and responsive to people’s needs.
• ReadmissionA subsequent inpatient hospital admission after discharge from a qualifying earlier admission, counted using a specified follow-up window, eligibility rule and treatment of planned returns and transfers.
• Readmission RateA measure of the proportion of patients readmitted to hospital within a defined period, commonly thirty days, after a prior discharge.
• Sentinel Event RateA sentinel event rate is the number of events meeting a specified serious patient-safety definition divided by a clearly defined population, activity, or exposure denominator during a stated period, usually expressed per a standard number of opportunities.
• SSI RateA measure of the frequency of surgical site infections following a procedure within a facility, a surgical infection prevention indicator.
• Standardised Mortality RatioA measure comparing actual deaths observed within a population against statistically expected deaths given its risk characteristics, above one meaning worse.
• Statistical Process ControlStatistical process control is a set of methods that monitors time-ordered process measurements to distinguish expected variation from signals of a possible process change.
• Stochastic Frontier AnalysisA parametric method estimating relative efficiency of comparable units by modelling an efficiency frontier while accounting for random statistical noise.
• ThroughputThroughput is the number of defined service units completed across a specified process boundary per unit of time.
• Trend AnalysisA statistical technique examining patterns of change in a variable over successive time periods, distinguishing direction from short-term fluctuation.
• Universal Health Coverage IndexA composite measure tracking a country's progress toward universal health coverage, summarising essential service availability across defined tracer indicators.
• Utilisation RateA measure of how frequently a service or resource is used within a population, typically expressed relative to population size.
• Utilisation ReviewTechniques payers use to assess and control appropriateness and volume of healthcare services, covering prior authorisation and claims review.
• VariationDifferences or spread in a measured characteristic across specified people, groups, services, places or times.