Article: Organisational performance evaluation: application to Belgian hospitals Journal: International Journal of Healthcare Technology and Management (IJHTM) 2002 Vol.4 No.1/2 pp.148-179 Abstract: In many Western countries, the hospital environment has completely changed in the last 20 years. Today|s hospitals cope with economical, technological and social pressures. One of the major changes is the generalisation of the Prospective Payment System or more controlled retrospective payment systems. This evolution yields new efficiency criteria that constrain many areas in healthcare management and forces hospital managers to revise completely the system of care production. In this volatile context, one new challenge for hospital managers is to find the most appropriate organisational design to face these more controlled payment systems. The above-mentioned challenge relies upon the link between the two following elements: performance evaluation and organisational design. This paper only analyses performance and is thus the first part of a larger research that grapples with this and more complicated issues. The first section of this paper is devoted to the elaboration of a performance model that would allow hospital evaluation and benchmarking. The problem that we face in developing such a model is that the criteria used to measure performance are conflicting. This forces us to perform a necessary arbitration between those performance criteria and raises a question related to which trade-offs are necessary. In the second section, we present a study conducted on 61 Belgian hospitals where we intend to highlight the existing link between some organisational parameters and hospital performance. In a first phase we use the DEA (Data Envelopment Analysis) approach to calculate performance scores for hospitals. A second phase analyses which factors can explain the variation of these performance scores. To perform this phase, we are greatly limited by the organisational factors data contained in our database. Observed variations in performance could be explained only by the following structural data private or public status and teaching or non-teaching character. We conclude with future research likely to define more accurately the relationship between organisational design and performance in the very specific field of healthcare management. Inderscience Publishers - linking academia, business and industry through research

Title: Organisational performance evaluation: application to Belgian hospitals

Authors: Muriel Creteur, Yves Pochet, Isabelle Pouplier, Marie-Christine Closon

Addresses: Unite de Gestion de la Production et des Operations, , Institut d'Administration et de Gestion, Universite Catholique de Louvain, 1 Place des Doyens, 1348 Louvain-la-Neuve, Belgium. Unite de Gestion de la Production et des Operations, , Institut d'Administration et de Gestion, Universite Catholique de Louvain, 1 Place des Doyens, 1348 Louvain-la-Neuve, Belgium. CIES, Public School of Health, Universite Catholique de Louvain, 1 Place des Doyens, 1348 Louvain-la-Neuve, Belgium. CIES, Public School of Health, Universite Catholique de Louvain, 1 Place des Doyens, 1348 Louvain-la-Neuve, Belgium

Abstract: In many Western countries, the hospital environment has completely changed in the last 20 years. Today|s hospitals cope with economical, technological and social pressures. One of the major changes is the generalisation of the Prospective Payment System or more controlled retrospective payment systems. This evolution yields new efficiency criteria that constrain many areas in healthcare management and forces hospital managers to revise completely the system of care production. In this volatile context, one new challenge for hospital managers is to find the most appropriate organisational design to face these more controlled payment systems. The above-mentioned challenge relies upon the link between the two following elements: performance evaluation and organisational design. This paper only analyses performance and is thus the first part of a larger research that grapples with this and more complicated issues. The first section of this paper is devoted to the elaboration of a performance model that would allow hospital evaluation and benchmarking. The problem that we face in developing such a model is that the criteria used to measure performance are conflicting. This forces us to perform a necessary arbitration between those performance criteria and raises a question related to which trade-offs are necessary. In the second section, we present a study conducted on 61 Belgian hospitals where we intend to highlight the existing link between some organisational parameters and hospital performance. In a first phase we use the DEA (Data Envelopment Analysis) approach to calculate performance scores for hospitals. A second phase analyses which factors can explain the variation of these performance scores. To perform this phase, we are greatly limited by the organisational factors data contained in our database. Observed variations in performance could be explained only by the following structural data private or public status and teaching or non-teaching character. We conclude with future research likely to define more accurately the relationship between organisational design and performance in the very specific field of healthcare management.

Keywords: hospital; healthcare systems; organisational design; performance evaluation; payment system; data envelopment analysis.

DOI: 10.1504/IJHTM.2002.001136

International Journal of Healthcare Technology and Management, 2002 Vol.4 No.1/2, pp.148-179

Published online: 30 Jun 2003 *

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Title: Organisational performance evaluation: application to Belgian hospitals

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