Evaluation of Performance Indicators of Qazvin Educational and Medical Centers before and after the Implementation of the Health System Transformation Plan: Interrupted Time Series Analysis

Bahman Ghasemzadeh, S. Shahsavari, Aisa Maleki, R. Kalhor
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Abstract

Background and Objectives: The present study was conducted to investigate the status of performance indicators in hospitals affiliated to Qazvin University of Medical Sciences before and after the implementation of the transformation plan. Methods: This descriptive-analytical study was performed longitudinally based on hospital data. The data collection tool was a checklist including general characteristics of hospitals and performance indicators. Data analysis was performed using Interrupted time series analysis (ITS) and Statistical software for data science (STATA) v.15. Chow test was used to determine the structural fractures in the studied time series. Results: Hospitals’ performance indicators were examined. In the first month after the intervention, bed rotation increased significantly by 1.148 (P<0.005). The trend of bed rotation after the intervention increased by 0.060 per month (P=0.032). In the first month after the intervention, the decrease or increase in the length of stay in different hospitals was not significant (P>0.005). The length of stay after the intervention increased by 0.170 per month. In the first month after the intervention, the decrease in bed occupancy percentage was 41% (P=0.005) which is significant. The trend of bed occupancy percentage after the intervention was more than 2% per month (P<0.005). Conclusion: The transformation plan in the period before and after implementation in all studied hospitals has positive effects and has made changes in most performance indicators. This plan is especially beneficial for people who have fallen ill due to a lack of financial resources and have not been able to seek treatment.
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加兹文教育医疗中心实施卫生体制转型计划前后绩效指标评价:中断时间序列分析
背景与目的:本研究旨在调查卡兹温医科大学附属医院在实施转型计划前后的绩效指标状况。方法:基于医院资料进行纵向描述性分析研究。数据收集工具是一份清单,包括医院的一般特征和绩效指标。使用中断时间序列分析(ITS)和数据科学统计软件(STATA) v.15进行数据分析。采用Chow检验确定研究时间序列中的结构性骨折。结果:对医院绩效指标进行了考核。在干预后的第一个月,床轮率显著增加了1.148 (P0.005)。干预后的住院时间每月增加0.170。干预后第一个月,住院率下降41% (P=0.005),差异有统计学意义。干预后床位占用率趋势为每月2%以上(P<0.005)。结论:所研究医院实施改造方案前后效果良好,大部分绩效指标发生了变化。这一计划对因缺乏财政资源而无法寻求治疗而患病的人尤其有益。
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