Analytic hierarchy process helps measure performance of hospitals

Measuring health care service performance is a complex task as it has multiple-functions, which contribute in aggregate towards achieving overall goals. There has been an increasing need of a tool for the process-based performance measurement of multispecialty tertiary care hospitals to identify the deficiencies in services and suggest recommendations for their improvement. Analytic Hierarchy Process (AHP), a multiple attribute decision-making technique, is utilized in this study to evolve a model to effectively measure the performance of the processes involved in the healthcare delivery of a hospital. Each step in the model was derived by group-discussions and brainstorming sessions among clinicians and managers with more than twenty years service in healthcare system. This tool was applied to a 600-bed tertiary care teaching hospital in Barbados, and another similar bed-strength tertiary care teaching hospital in South India. The cumulative performance rating of the Barbados hospital was 0.38 when compared to the cumulative performance rating of the Indian hospital which was 0.27. Gap analysis showed that the Indian hospital performed at 71% with respect to Barbados hospital. The model enabled identification of specific areas where either hospital did not perform very well, and helped to suggest recommendations to improvise those areas. We recommend analytic hierarchy process as a valuable tool to measure the process-based performance of a multispecialty tertiary care hospital.