Noto Guido, Lo Verso Andrea Carlo, Barresi Gustavo
Department of Economics, University of Messina, Messina, Italy.
Department of Management, University of Bologna, Bologna, Italy.
BMC Health Serv Res. 2021 Apr 9;21(1):326. doi: 10.1186/s12913-021-06332-4.
Both the concept of performance and the role of hospitals in health systems evolved significantly in the last decades. Today, the performance in health could be defined as the ability to create 'population value,' and the hospitals' role is to support this aim by providing acute care and by integrating and coordinating their activity with other settings of care. This research aims to assess how and with what degree the management of public hospitals have embraced in practice the updated concept of performance and their new role.
The paper analyses 181 performance plans of 48 Italian autonomous public hospitals over a nine-year period through the topic modeling algorithm called Latent Dirichlet Allocation (LDA). This is a method that allows for analysing large textual corpora that generates a representation of the latent topics discussed therein. The concept of performance in public hospitals was framed into 15 topics resulting from the analysis of the hospitals' performance plans. The prevalence of each topic was analysed through the period considered so as to understand the evolution of performance-related practices over the last decade.
In recent years, the concept of performance in hospitals evolved toward the adoption of an outcome-based and population-based perspective. Additional effort should be devoted toward improved collaboration and integration of care with other settings.
在过去几十年中，绩效概念以及医院在卫生系统中的作用都发生了显著演变。如今，卫生领域的绩效可定义为创造“人群价值”的能力，而医院的作用是通过提供急症护理以及将其活动与其他护理机构进行整合与协调来支持这一目标。本研究旨在评估公立医院管理层在实践中如何以及在何种程度上接受了更新后的绩效概念及其新角色。
本文通过名为潜在狄利克雷分配（LDA）的主题建模算法，对48家意大利自治公立医院在九年期间的181份绩效计划进行了分析。这是一种能够分析大型文本语料库并生成其中所讨论潜在主题表征的方法。公立医院的绩效概念被归纳为15个主题，这些主题源于对医院绩效计划的分析。对每个主题在研究期间的流行程度进行了分析，以了解过去十年中与绩效相关实践的演变情况。
近年来，医院绩效概念已朝着采用基于结果和基于人群的视角发展。应进一步努力加强与其他机构的协作以及护理整合。
