Towards the development of a conceptual framework for hospital performance assessment of a South African public hospital in the Eastern Cape province

An integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals, is not available. The aim of this study was therefore to contribute to the development of a conceptual framework for assessing the performance of a SA public hospital in the Eastern Cape Province. The systematic literature review included all black and grey literature that relate to one of the two main themes- the purpose of measuring hospital performance and the methodology of assessing hospital performance. Relevant studies were identified through a Google search using the following descriptors: “Hospital Performance”, and “Hospital Performance Assessment”. There were 369 scholarly articles with the exact descriptors anywhere in the article with 59 articles released during the period 2012 to 2016. Ultimately, 7 articles met all the inclusionary criteria and described enterprise wide assessments of hospital performance. Other relevant articles, inclusive of grey literature, are included. Two of the studies in Morocco and Costa Rica were systematic reviews of hospital performance and covered the period 2000-2011. The Botswana case study assessed the use of the WHO PATH tool to measure the performance of its public hospitals. The Iranian, United States and Malaysian studies reflected on single aspect measures of hospital performance such as efficiency; the effect of weighting hospital performance indicators for patient harm on hospital profiles and payment; and Bed Occupancy rates, respectively. The review of the challenges associated with developing a hospital performance assessment framework was not found to be as useful as the other articles. The WHO PATH tool provides a high level integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals. This, however, needs to be adapted to the South African context with specific indicators being selected by local stakeholders that will promote best possible patient outcomes and a positive experience of patient-centred care at effective and efficient public health facilities. Lessons can be drawn from other countries’ experiences that have implemented hospital performance assessments and tested specific performance indicators