From Strategic Planning to Operations: A Decision Support Mechanism for Care Delivery in a Tertiary Hospital in China.

With China introducing diagnosis-related groups to insurance payment policies as a component of health care reform, the emphasis on operational management has become increasingly important and specific. Under the current payment and evaluation system, tertiary-level public hospitals are facing escal...

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Publicado en:NEJM Catalyst Innovations in Care Delivery Vol. 6; pp. 1 - 20
Autores principales: Xin, Yu, Tang, Huimin, Gao, Peng, Chen, Hu, Xie, Xiaolei
Formato: Journal Article
Publicado: New England Journal of Medicine 2025 Supplement 1
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2025 Supplement 1
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      pub: New England Journal of Medicine
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        10.1056/CAT.25.0153
        190744023
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        atl: From Strategic Planning to Operations: A Decision Support Mechanism for Care Delivery in a Tertiary Hospital in China.
      aug:
        au:
          Xin, Yu
          Tang, Huimin
          Gao, Peng
          Chen, Hu
          Xie, Xiaolei
        affil: Research Assistant, Research Center for Healthcare Data Standard, Institute for Hospital Management, Tsinghua University, Beijing, China
      sug:
        subj:
          Strategic Planning
          Decision Support Systems, Management
          Health Care Delivery
          Tertiary Health Care China
          Health Facility Administration
          China
          Health Care Reform
          Decision Making, Computer Assisted
          Diagnosis-Related Groups
          Value-Based Health Care
          Health Resource Allocation
          Performance Measurement Systems
          Planning Techniques
          Feedback
      ab: With China introducing diagnosis-related groups to insurance payment policies as a component of health care reform, the emphasis on operational management has become increasingly important and specific. Under the current payment and evaluation system, tertiary-level public hospitals are facing escalating pressures to reconcile competing priorities such as case mix index, bed utilization, and value-based revenue growth. In collaboration with a 1500-bed tertiary public hospital, the authors developed a data-driven decision support mechanism, designed to be used from strategic planning through operations, while pursuing performance improvements under resource constraints. With the use of this mechanism, a system was developed to transform hospital performance metrics into actionable plans. This system was designed to be capable of adjusting to unmet goals and aligning with seasonal demand fluctuations. Mixed-integer programming models were employed to enable the balancing of competing goals to achieve operational excellence, and bidirectional feedback was used to resolve top-down and bottom-up mismatches, ensuring alignment between hospital-level goals and department-level execution. Utilizing deidentified data from the hospital, the authors demonstrated that the system, in scenario-based case mix planning iterations, is potentially capable of improving performance metrics with reasonable trade-offs. Future research aims at extending the framework to provide a holistic solution to support hospitals in achieving operational excellence by enhancing medium- to long-term resource planning, dynamically aligning supply with demand and, ultimately, leading to a new operational pattern for hospitals. A tertiary hospital in Beijing developed a data-driven analytical framework to bridge the gap between strategic objectives and operational practices.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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