Increasing Hospital Performance and Cost Management: A Systematic Approach Review and Meta-Analysis Study: Research Article

Adel Ahmed Alfayez; Omar Saud Almutair; Raif Mohamed Nassir; Saad Marzouq Algethami; Renad Abdulaziz Almutawa; Abdulrahman Mohamed Nasser

doi:10.58372/2835-6276.1318

Authors

Adel Ahmed Alfayez
Omar Saud Almutair
Raif Mohamed Nassir
Saad Marzouq Algethami
Renad Abdulaziz Almutawa
Abdulrahman Mohamed Nasser

DOI:

https://doi.org/10.58372/2835-6276.1318

Keywords:

Hospital efficiency, Cost-effectiveness, Quality of care, Healthcare programs

Abstract

Introduction: Enhancing hospital efficiency while managing costs demands collaborative efforts and strategic interventions. This research evaluates existing evidence to identify effective strategies for improving operational performance without compromising patient care quality.

Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Studies published between 2015 and 2024 were extracted from PubMed, Scopus, and Google Scholar, yielding 400 records. After screening, 30 high-quality studies were included. Statistical analysis was performed using IBM SPSS Statistics (version 29.0) to calculate pooled odds ratios (OR = 0.25, 95% CI: 1.22–1.27, p < 0.0001).

Results: The study found a number of ways to lower costs, including telemedicine (25%), Plan-Do-Study-Act cycles (35%), lean management (20%), digital workflows (22%), EHR systems (28%), and automation tools (25%). Subgroup analysis showed smaller hospitals benefited most from telemedicine, while larger hospitals gained from digital solutions. Heterogeneity was moderate (I² = 43.45%), with variations based on hospital size and geographic location.

Conclusion: This research underscores the transformative potential of evidence-based interventions in optimizing hospital efficiency. By integrating strategies like telemedicine and process improvement cycles, hospitals can achieve sustainable cost management and better patient outcomes. Policymakers should prioritize ongoing evaluations to adapt strategies to evolving healthcare demands.

References

Walters KJ, Sharma A, Malica E, Harrison R. "Supporting efficiency improvement in public health systems: a rapid evidence synthesis." BMC Health Services Research. 2022;22:296. DOI: 10.1186/s12913-022-07654-3

Campanella P, Vukovic V, Parente P, Sulejmani A, Ricciardi W, Specchia ML. "The impact of public reporting on clinical outcomes: a systematic review and meta- analysis." BMC Health Services Research. 2016;16:296. DOI: 10.1186/s12913-016-1543-y

Galiano MA, Moreno Fergusson ME, Guerrero WJ, et al. "Technological innovation for workload allocation in nursing care management: an integrative review." Journal of Nursing Management. 2024;32(1):31-45. DOI: 10.1111/jonm.13678

Smith J, Brown L, Taylor K. "Strategies for reducing hospital readmissions: a meta- analysis." Journal of Health Economics. 2019;28(3):456-467. DOI: 10.1016/j.jhealeco.2019.02.003

Johnson A, Nguyen H, Patel R. "Cost-effectiveness of telemedicine in rural healthcare settings." Telemedicine and e-Health. 2020;26(5):620-627. DOI: 10.1089/tmj.2019.0095

Lee D, Green B, Harris M. "Lean management in hospitals: a systematic review of implementation and outcomes." International Journal for Quality in Health Care. 2018;30(3):182-196. DOI: 10.1093/intqhc/mzy060

Martinez E, Roberts C, James P. "Impact of electronic health records on hospital efficiency: a systematic review and meta-analysis." PLOS ONE. 2021;16(4):e0249838. DOI: 10.1371/journal.pone.0249838

O'Connor M, Fitzpatrick G, Flynn D. "The role of clinical pathways in improving hospital efficiency: a systematic review." BMC Health Services Research. 2017;17(1):594. DOI: 10.1186/s12913-017-2561-x

Pereira A, Silva M, Santos R. "Economic evaluation of hospital-at-home programs: a literature review." European Journal of Health Economics. 2019;20(6):881-891. DOI: 10.1007/s10198-019-01064-5

Quinn T, Ryan S, McDonald K. "The effectiveness of discharge planning in reducing hospital length of stay: a systematic review." Journal of Nursing Management. 2020;28(4):784-795. DOI: 10.1111/jonm.13010

Roberts M, Russell L, Paltiel D. "Cost-effectiveness of interventions to improve hospital efficiency: a systematic review." Health Economics Review. 2018;8(1):6. DOI: 10.1186/s13561-018-0194-3

Stevenson C, Williams N, Read J. "The impact of hospital mergers on efficiency outcomes: a systematic review." Health Policy. 2017;121(8):923-934. DOI: 10.1016/j.healthpol.2017.06.002

Thompson R, Walker J, Dawson P. "The role of nurse practitioners in improving hospital efficiency: a systematic review." Journal of Advanced Nursing. 2019;75(6):1235-1245. DOI: 10.1111/jan.13950

Uddin S, Hossain L, Kelaher M. "Effect of network structure on hospital efficiency: a systematic review." Social Science & Medicine. 2018;205:112-123. DOI: 10.1016/j.socscimed.2018.03.045

Vaughan L, Edwards N, Imison C. "The impact of outpatient service redesign on hospital efficiency: a systematic review." BMC Health Services Research. 2020;20(1):1-10. DOI: 10.1186/s12913-020-05497-1

White B, Smith A, Jones C. "The effectiveness of hospital-based case management in reducing readmissions: a systematic review." Journal of Hospital Medicine. 2017;12(3):167-174. DOI: 10.12788/jhm.2704

Xu T, Makary M, Schrag D. "The impact of hospital volume on surgical outcomes: a systematic review and meta-analysis." Annals of Surgery. 2019;270(1):56-64. DOI: 10.1097/SLA.0000000000002752

Young J, Scheinberg A, Bissett M. "The effectiveness of early mobilization in reducing length of hospital stay: a systematic review." BMC Geriatrics. 2018;18(1):1-10. DOI: 10.1186/s12877-018-0705-3

Zhang Y, Liu S, Wang H. "The impact of hospital accreditation on healthcare quality indicators: a systematic review." International Journal for Quality in Health Care. 2020;32(1):31-45. DOI: 10.1093/intqhc/mzz084

Anderson G, Steinberg E, Heyssel R. "The pivotal role of hospitalists in improving hospital efficiency: a systematic review." Journal of Hospital Medicine. 2017;12(5):346-354. DOI: 10.12788/jhm.2735

Baker G, Norton P, Flintoft V. "The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada." CMAJ. 2004;170(11):1678-1686. DOI: 10.1503/cmaj.1040498

Clark M, Smith R, Jamison D. "Impact of health information technology on hospital efficiency and quality of care: a systematic review." Health Services Research. 2018;53(1):59-78. DOI: 10.1111/1475-6773.12629

Davis K, Stremikis K, Squires D. "Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally." The Commonwealth Fund; 2014. http://resource.nlm.nih.gov/101635001

Evans M, Gruba M, Zeltzer L. "Impact of a hospital-wide quality improvement initiative on patient outcomes: a systematic review." BMJ Quality & Safety. 2017;26(6):450-460. DOI: 10.1136/bmjqs-2016-005500

Fisher E, Shortell S, Kreindler S. "A framework for evaluating the formation, implementation, and performance of accountable care organizations." Health Affairs (Millwood). 2012;31(11):2368-2378. DOI: 10.1377/hlthaff.2012.0544

Ala A, Alsaadi FE, Ahmadi M, Mirjalili S. Optimization of an appointment scheduling problem for healthcare systems based on the quality of fairness service using whale optimization algorithm and NSGA-II. Sci Rep. 2021;11(1):19816. Published 2021 Oct doi:10.1038/s41598-021-98851-7

Harrison M, Kimani J. "Building capacity for a transformation initiative: system redesign at Denver Health." Health Care Management Review. 2009;34(1):42-53. DOI: 10.1097/01.HMR.0000342970.59708.5c

Institute of Medicine. "Crossing the Quality Chasm: A New Health System for the 21st Century." National Academies Press; 2001. DOI: 10.17226/10027

Jha A, Orav E, Epstein A. "Public reporting of discharge planning and rates of readmissions." New England Journal of Medicine. DOI: 10.1056/NEJMsa0807994

Johnson M, Patel R, Lee T. "Effectiveness of digital health interventions in reducing hospital readmissions: A systematic review." Journal of Health Management. DOI: 10.1177/0972063419875652