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

Abstract 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,...

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Main Authors: Faten Amer, Sahar Hammoud, Haitham Khatatbeh, Szimonetta Lohner, Imre Boncz, Dóra Endrei
Format: Article
Language:English
Published: BMC 2022-05-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-022-07863-0
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author Faten Amer
Sahar Hammoud
Haitham Khatatbeh
Szimonetta Lohner
Imre Boncz
Dóra Endrei
author_facet Faten Amer
Sahar Hammoud
Haitham Khatatbeh
Szimonetta Lohner
Imre Boncz
Dóra Endrei
author_sort Faten Amer
collection DOAJ
description Abstract 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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spelling doaj.art-7e91e50606f447cf945c7fb09eb838a52022-12-22T00:38:21ZengBMCBMC Health Services Research1472-69632022-05-0122112210.1186/s12913-022-07863-0A systematic review: the dimensions to evaluate health care performance and an implication during the pandemicFaten Amer0Sahar Hammoud1Haitham Khatatbeh2Szimonetta Lohner3Imre Boncz4Dóra Endrei5Doctoral School of Health Sciences, Faculty of Health Sciences, University of PécsDoctoral School of Health Sciences, Faculty of Health Sciences, University of PécsDoctoral School of Health Sciences, Faculty of Health Sciences, University of PécsClinical Center of the University of Pécs, Medical School, Cochrane Hungary, University of PécsFaculty of Health Sciences, Institute for Health Insurance, University of PécsFaculty of Health Sciences, Institute for Health Insurance, University of PécsAbstract 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.https://doi.org/10.1186/s12913-022-07863-0Balanced scorecardPerformanceIndicatorsHealthHospitalEvaluation
spellingShingle Faten Amer
Sahar Hammoud
Haitham Khatatbeh
Szimonetta Lohner
Imre Boncz
Dóra Endrei
A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic
BMC Health Services Research
Balanced scorecard
Performance
Indicators
Health
Hospital
Evaluation
title A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic
title_full A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic
title_fullStr A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic
title_full_unstemmed A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic
title_short A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic
title_sort systematic review the dimensions to evaluate health care performance and an implication during the pandemic
topic Balanced scorecard
Performance
Indicators
Health
Hospital
Evaluation
url https://doi.org/10.1186/s12913-022-07863-0
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