Measuring hospitals performance: Applying the management approach in Nepal

ABSTRACT

The paper has twofold objectives: to measure management practices from the employer perspective of both public and private hospitals of Nepal and to explore the relationship between management practices and output indicators of the hospitals by utilizing data collected from a primary survey. The total sample size of the hospital was 100. Among the total hospitals, 33% were public hospitals while 67% were private hospitals. The double-blind in-depth survey technique was adapted in order to measure management practices. A single management score was developed by giving equal weightage for all 18 questions. Ordinary least squares were used to establish the relationship between management practices and outputs of the hospitals. The result suggests that the average management score is found to be 2.04, 95% confidence interval (CI) 1.93–2.15. The management score is slightly higher for private hospitals (2.08) than for public hospitals (1.94); however, this difference is not statistically significant. Average management scores are strongly associated with total inpatient days, infection prevention practice score, bed occupancy rate, and inpatient days per technical staff. These associations are statistically significant at the 1% level and each regression model has an R² value greater than 34. In conclusion, management practices can be measured using the systematic tool and compared across the hospitals. Better management practices are strongly associated with the indicators of performance of the hospitals.

KEYWORDS:

• Management practices
• hospital
• performance
• Nepal

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Shiva Raj Adhikari is an associate professor in department of economics, Patan multiple campus, Tribhuvan university, Nepal. He received his PhD in health economics from Chulalongkorn University, Bangkok, Thailand. He has remained active in doing researches on economic and health policy issues particularly on impact on public policy on household economy, hospital efficiency and management, equity in health financing and delivery, economic evaluation, cost–benefit and cost-effectiveness analysis, risk of disease and poverty among others. He has published more than two dozen articles in international peer-reviewed journals.

Vishnu Prasad Sapkota is an assistant lecturer in the institute of medicine, Tribhuvan University, Maharakganj, Nepal. He did his M.Sc. in Public Health from University of Southern Denmark, Denmark. His research interest includes economic evaluation, cost analysis of health programmes and facilities, choice experiments: design and analysis, efficiency and productivity analysis of health and social service organizations, among others. He has published several papers in various reputed journals.

ORCID

Shiva Raj Adhikari http://orcid.org/0000-0002-4642-8606

Vishnu Prasad Sapkota http://orcid.org/0000-0002-4014-8267

Additional information

Funding

Financial support for the survey of this study was provided by the Private Enterprise Development for Low-Income Countries (PEDL), Centre for Economic Policy Research (CEPR), UK [grant number LOA_EGLIC_1754].