Patients’ increasing needs and expectations demand for an
overall assessment of hospital performances. Several Agencies
described sets of performance indicators and there is not a
unanimous classification. The ImpactHTA Horizon2020
Project wants to address this aspect, developing a toolkit of
key indicators to measure hospital organizational performance.
The aim of this review is to identify the dimensions of quality
in which hospital performance indicators are grouped, and to
assess if there has been an evolution over time of the abovementioned
Following the PRISMA statement, PubMed, Ovid and Web of
Science databases were queried to perform an umbrella review.
Articles focusing on secondary care settings, published January
2000-May 2018 were considered. The study design included
was systematic review.
3680 records were screened and 6 systematic reviews ranging
2002-2014 were included. The following dimensions were
described in at least 50% of the studies: 6 studies classified
efficiency (53 indicators analyzed); 5 studies classified effectiveness
(12 indicators), patient centeredness (10 indicators)
and safety (8 indicators); 3 studies responsive governance (2indicators), staff orientation (8 indicators) and timeliness (4
indicators). 3 reviews did not specify the indicators related to
the dimensions listed, 1 gave a complete definition of the
meaning of each dimension and related indicators.
The research shows steady awareness of the importance of
patient centeredness, effectiveness, efficiency, and safety
dimensions; apparently, there is still not much attention to
sustainability, appropriateness and accessibility in terms of
indicators measuring, although those dimensions are
described in one of the latest review. Another review
described a new dimension, resources and capacity, which
focuses on the availability of new technologies, underlining
the growing importance of the adoption of digitalization in
Main dimensions of performance indicators: efficiency,
effectiveness, patient centeredness, safety.
More emphasis to sustainability and appropriateness to
align with today’s healthcare challenges.