Implications and future strategies on cost management for hospitals during and after COVID-19

Raghuvanshi, Vijay Pratap; Raghuvanshi, Shiv Pratap

doi:10.18203/2394-6040.ijcmph20202507

Cited by 8 publications

(7 citation statements)

References 2 publications

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“…In contrast, other hospitals will experience mostly sharp reductions in elective and outpatient payments, which will create unprecedented financial challenges for HCO [ 89 ]. However, in addition to the higher costs of HCWs and resources, researchers found higher costs of treatment due to extra diagnostic tests and isolation costs [ 90 ].…”

Section: Discussionmentioning

confidence: 99%

A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic

Amer

Hammoud

Khatatbeh

et al. 2022

BMC Health Serv Res

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Background The balanced scorecard (BSC) has been implemented to evaluate the performance of health care organizations (HCOs). BSC proved to be effective in improving financial performance and patient satisfaction. Aim This systematic review aims to identify all the perspectives, dimensions, and KPIs that are vital and most frequently used by health care managers in BSC implementations. Methods This systematic review adheres to PRISMA guidelines. The PubMed, Embase, Cochrane, and Google Scholar databases and Google search engine were inspected to find all implementations of BSC at HCO. The risk of bias was assessed using the nonrandomized intervention studies (ROBINS-I) tool to evaluate the quality of observational and quasi-experimental studies and the Cochrane (RoB 2) tool for randomized controlled trials (RCTs). Results There were 33 eligible studies, of which we identified 36 BSC implementations. The categorization and regrouping of the 797 KPIs resulted in 45 subdimensions. The reassembly of these subdimensions resulted in 13 major dimensions: financial, efficiency and effectiveness, availability and quality of supplies and services, managerial tasks, health care workers' (HCWs) scientific development error-free and safety, time, HCW-centeredness, patient-centeredness, technology, and information systems, community care and reputation, HCO building, and communication. On the other hand, this review detected that BSC design modification to include external and managerial perspectives was necessary for many BSC implementations. Conclusion This review solves the KPI categorization dilemma. It also guides researchers and health care managers in choosing dimensions for future BSC implementations and performance evaluations in general. Consequently, dimension uniformity will improve the data sharing and comparability among studies. Additionally, despite the pandemic negatively influencing many dimensions, the researchers observed a lack of comprehensive HCO performance evaluations. In the same vein, although some resulting dimensions were assessed separately during the pandemic, other dimensions still lack investigation. Last, BSC dimensions may play an essential role in tackling the COVID-19 pandemic. However, further research is required to investigate the BSC implementation effect in mitigating the pandemic consequences on HCO.

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Section: Discussionmentioning

confidence: 99%

A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic

Amer

Hammoud

Khatatbeh

et al. 2022

BMC Health Serv Res

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“…This contributed to reassurance of the public about safety of care and protected staff who were not directly caring for COVID-19 patients. The need for medical providers to resume elective procedures as an important source of income, in face of the heavy medical costs of the pandemic, might be another motive for the increase in MRI activity [ 31 ]. These measures might explain the phenomenon demonstrated during the second wave.…”

Section: Discussionmentioning

confidence: 99%

National and regional trends in MRI utilization in the face of the ongoing COVID-19 pandemic

Luxenburg

Saban

Myers

et al. 2021

Isr J Health Policy Res

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Background and purpose Marked reductions in imaging exams have been documented during the COVID-19 pandemic. The study aimed to examine the effect of the two waves of COVID-19 on magnetic resonance imaging (MRI) utilization at the national and regional level. Materials and methods A retrospective-archive study was conducted in Israel, comparing March–December 2020 with March–December 2018 and 2019. Data on MRI utilization were obtained from the national MRI registry, while data on confirmed COVID-19 cases, by place of residence, were obtained from the Israeli Ministry of Health open COVID-19 database. Results The number and rate of MRI examinations decreased during the first COVID-19 wave, with the steepest drop in April 2020: 47.5% relative decrease compared to April 2019, and 42.2% compared to 2018. This was followed by a compensatory increase between the waves and a return to almost pre-pandemic levels of use, with just a modest decrease, during the second, more intense COVID wave, compared with the previous year. Existing differences between regions increased during the pandemic. The rate ratio of MRI exams between Tel-Aviv and the Northern periphery increased from 2.89 in April 2019 to 3.94 in April 2020. Jerusalem metropolitan region, with the largest burden of COVID disease, demonstrated only a modest decrease (1%) in MRI utilization during the first 10 months of the pandemic. Conclusions At the national level, time trends in reduced MRI utilization followed the first wave of COVID-19, and were accompanied by increased regional disparities. These changes were not explained by differences in the burden of COVID-19 disease but might be explained by unequal distribution of MRI scanners among regions. Reduced utilization was not evident during the second wave, nor at the beginning of the third wave, despite higher COVID-19 case load, demonstrating adaptation to the new normal. Patterns of MRI utilization might help policy-makers and healthcare managers predict the behavior of imaging as well as other sectors, such as elective surgical procedures, during an ongoing pandemic. This forecast might help to manage the lasting effects of the pandemic, including extended waiting times, in the months and years following its remission. In preparation for future national emergencies, timely and detailed data on MRI utilization can serve as a “sensor” for a wide array of diagnostic and interventional medical activities, providing policy-makers with an updated snapshot to guide their response at the regional and national levels.

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“…In contrast, other hospitals will experience mostly sharp reductions in elective and outpatient revenues, which will create unprecedented financial challenges for HCOs [80]. However, in addition to the greater costs of HCWs and resources, researchers found higher costs of treatment occurred as a result of extra diagnostic tests and isolation costs [81].…”

Section: The Financial Dimension In Covid-19mentioning

confidence: 99%

A Systematic Review: The Dimensions utilized in the Performance Evaluation of Healthcare- An Implication during the COVID-19 Pandemic

Amer

Hammoud

Khatatbeh

et al. 2021

Preprint

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This systematic review aims to identify the Key Performance Indicators (KPIs) which are the most frequently used and important in the Performance Evaluation (PE) of Health Care Organizations (HCOs). Also, it aimed to analyze the resulted Balanced Scorecard (BSC) dimensions during the Coronavirus Disease 2019 (COVID-19) era. This systematic review was prepared according to PRISMA guidelines. PubMed, Embase, Cochrane, and Google Scholar databases, as well as Google search engine, were inspected to find all implementations of BSC at HCOs until 20 September 2020. The Risk of Bias (RoB) was assessed for each included article. The eligible studies were 33, in which 36 BSC implementations were identified. The categorization and re-grouping of the 797 KPIs resulted in 13 major-dimensions: The financial, efficiency and effectiveness, availability and quality of supplies and services, managerial tasks, Health Care Workers (HCWs) scientific development error-free and safety, the time, HCW-centeredness, patient-centeredness, technology and information system, community care and reputation, HCO building, and the communication. Under them, 45 sub-dimension were identified. The high RoB in most implementations was due to the selection bias. None of the 36 BSC implementations was utilized during the COVID-19 pandemic. This review solves the dilemma of categorization differences among BSC implementations, which in turn will improve the data sharing and comparability among studies. A modification for the BSC design to include external and managerial perspectives is required. However, a lack of a comprehensive PE for HCOs during the pandemic was observed, so the resulted dimensions and KPIs are recommended for planning, monitoring, evaluation, and continuous improvement of HCOs. Many dimensions were negatively influenced by the pandemic. However, some dimensions still need further investigation. BSC dimensions have an essential role in tackling the COVID-19 pandemic and will help the health care managers to mitigate its consequences on HCOs.

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Implications and future strategies on cost management for hospitals during and after COVID-19

Cited by 8 publications

References 2 publications

A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic

A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic

National and regional trends in MRI utilization in the face of the ongoing COVID-19 pandemic

A Systematic Review: The Dimensions utilized in the Performance Evaluation of Healthcare- An Implication during the COVID-19 Pandemic

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