A Knowledge Based Search Tool for Performance Measures in Health Care Systems

Abstract

Performance measurement is vital for improving the health care systems. However, we are still far from having accepted performance measurement models. Researchers and developers are seeking comparable performance indicators. We developed an intelligent search tool to identify appropriate measures for specific requirements by matching diverse care settings. We reviewed the literature and analyzed 229 performance measurement studies published after 2000. These studies are evaluated with an original theoretical framework and stored in the database. A semantic network is designed for representing domain knowledge and supporting reasoning. We have applied knowledge based decision support techniques to cope with uncertainty problems. As a result we designed a tool which simplifies the performance indicator search process and provides most relevant indicators by employing knowledge based systems.

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References

  1. 1.

    World Health Report, Health systems-improving performance. World Health Organization, Geneva, Switzerland, p. 215, 2000.

    Google Scholar 

  2. 2.

    Kazandjian, V. A., Matthes, N., and Wicker, K. G., Are performance indicators generic? The international experience of the Quality Indicator Project. J. Eval. Clin. Pract. 9(2):265–276, 2003.

    Article  Google Scholar 

  3. 3.

    Murray, C. J. L., and Frenk, J. A., Framework for assessing the performance of health systems. Bull. WHO. 78(6):717–731, 2000.

    Google Scholar 

  4. 4.

    Jones, A. M., The Elgar companion to health economics. Edward Elgar Publishing Limited, Cheltenham, UK, p. 584, 2006.

    Google Scholar 

  5. 5.

    Pandey, D. K., Cursio, J. F., and CAPTURE Stroke Investigators, Data feedback for quality improvement of stroke care: CAPTURE stroke experience. Am. J. Prev. Med. 31(6 supp2):S224–S229, 2006.

    Article  Google Scholar 

  6. 6.

    Kazandjian, V., and Lied, T., Healthcare performance measurement: systems design and evaluation. ASQ Quality, Milwaukee, p. 234, 2002.

    Google Scholar 

  7. 7.

    Kirigia, J. M., Emrouznejad, A., Cassoma, B., Asbu, E. Z., and Barry, S., A performance assessment method for hospitals: the case of municipal hospitals in Angola. J. Med. Syst. (32):509–519, 2008.

  8. 8.

    Unruh, L., and Wan, T. T. H., A systems framework for evaluating nursing care quality in nursing homes. J. Med. Syst. 28(2):197–214, 2004.

    Article  Google Scholar 

  9. 9.

    Arah, O. A., Westert, G. P., Jeremy, H., and Klazinga, N. S., A conceptual framework for the OECD Health Care Quality Indicators Project. Int. J. Qual. Health Care. Sept., 5–13, 2006.

  10. 10.

    Edward, K., and Jeremy, H., OECD Health Working Papers No 23, Health Care Quality Indicators Project. Conceptual Framework Paper, DELSA/HEA/WD/HWP, 2006.

  11. 11.

    Anderson, J., Hackman, M., Burnich, J., and Gurgiolo, T. R., Determining hospital performance based on rank ordering: is it appropriate? Am. J. Med. Qual. (22):177–185, 2007.

  12. 12.

    Silver, M. P., Geis, M. S., and Bateman, K. A., Improving health care systems performance: a human factors approach. Am. J. Med. Qual. 19(3):93–102, 2004.

    Article  Google Scholar 

  13. 13.

    Keyes, M. A., CONQUEST 2.0: An emerging clinical performance measurement tool. J. Healthc. Qual. 22(3):29–36, 2000.

    Article  Google Scholar 

  14. 14.

    Gennari, J. H., Musen, M. A., Fergerson, R. W., Grosso, W. E., Crubézy, M., Eriksson, H., Noy, N. F., and Tu, S. W., The evolution of Protégé: an environment for knowledge-based systems development. Int. J. Hum. Comput. Stud.. (58):89–123, 2003.

  15. 15.

    Decision support systems, achievements, trends and challenges for the new decade, Mora M., Forgionne G.A., Gupta J. N. D., IDEA Group Publishing, Hershey, USA, 2003. Chapter II:Categorizing Decision Support Systems: A Multidimensional Approach, D. J. Power, Pg 20–27.

  16. 16.

    Liao, S., Knowledge management technologies and applications—literature review from 1995 to 2002. Expert. Syst. Appl. 25(2):155–164, 2003.

    Article  Google Scholar 

  17. 17.

    Shue, L. Y., Chen, C. W., and Shiue, W., The development of an ontology-based expert system for corporate financial rating. Expert. Syst. Appl. 36(2, Part 1):2130–2142, 2009.

    Article  Google Scholar 

  18. 18.

    Musen, M. A., Modern architectures for intelligent systems: reusable ontologies and problem-solving methods. In: Chute, C. G. (Ed.), Proceedings of the AIMA’98 (pp. 46–52). Orlando, FL, 1998.

  19. 19.

    Taboada, M., Martínez, D., and Mira, J., Experiences in reusing knowledge sources using Protégé and PROMPT. Int. J. Hum. Comput. Stud. 62(5):597–618, 2005.

    Article  Google Scholar 

  20. 20.

    Bhatt, M., Rahayu, W., Soni, S. P., and Wouters, C., Ontology driven semantic profiling and retrieval in medical information systems. J. Web Sem. 7(4):317–331, 2009.

    Article  Google Scholar 

  21. 21.

    Marinov M., and Zheliazkova I., An interactive tool based on priority semantic networks. Knowl. Based Syst.. (18):71–77, 2005.

  22. 22.

    Hartley, R. T., and Barnden, J. A., Semantic networks: visualizations of knowledge. Trends Cogn. Sci. 1(5):169–175, 1997.

    Article  Google Scholar 

  23. 23.

    Abu-Hanna, A., Cornet, R., Keizer, N., Crubézy, M., and Tu, S. W., Protégé as a vehicle for developing medical terminological systems. Int. J. Hum. Comp. Stud. 62(5):639–663, 2005.

    Article  Google Scholar 

  24. 24.

    Introduction to Fuzzy Logic using MATLAB, S. N. Sivanandam, S. Sumathi and S. N. Deepa, Springer, 2007.

  25. 25.

    Baykal, N., and Beyan, T., Bulanık Mantık, İlke ve Temelleri. Bıçaklar, 2004, pp 413.

  26. 26.

    Evans, D. B., Edejer, T. T., Lauer, J., Frenk, J., and Murray, C. J. L., Measuring quality: from system to the provider. Int. J. Qual. Health Care. 13(6):439–446, 2001.

    Article  Google Scholar 

  27. 27.

    Koss, R. G., Hanold, L. S., and Loeb, J. M., Integrating healthcare standards and performance measurement. Dis. Manage. Health Outcomes. 10(2):81–84, 2002.

    Article  Google Scholar 

  28. 28.

    Chen, C., Hong, M., and Hsu, Y., Administrator self-rating of organization capacity and performance of healthy community development projects in Taiwan. Pub. Health Nur. 24(4):343–354, 2007.

    Article  Google Scholar 

  29. 29.

    Perrin, E. B., Durch, J. S., and Skillman, S. M., Health performance measurement in the public sector. National Academy, Washington, D.C, p. 176, 1999.

    Google Scholar 

  30. 30.

    Shengelia, B., Tandon, A., Adams, O. B., and Murray, C. J. L., Access, utilization, quality, and effective coverage: an integrated conceptual framework and measurement strategy. Soc. Sci. Med.. (61):97–109, 2005.

  31. 31.

    Bodenheimer, T. S., and Grumbach, K., Understanding health policy, a clinical approach. Lange Medical Books, McGraw-Hill, The New York, NY, p. 222, 2009.

    Google Scholar 

  32. 32.

    OECD, A system of health accounts, head of publications service. OECD, France, p. 209, 2000.

    Google Scholar 

  33. 33.

    Aday, L. A., Begley, C. E., Lairson, D. R., and Balkrishnan, R., Evaluating the healthcare system, effectiveness, efficiency and equity. Health Administration, Chicago, p. 334, 2004.

    Google Scholar 

  34. 34.

    Penney, C., and Henry, E., Improving performance management for delivering appropriate care for patients no longer needing acute hospital care. J. Health Serv. Res. Policy. 13(1):30–34, 2008.

    Article  Google Scholar 

  35. 35.

    Bernard, D. B., Coburn, K. D., Miani, M. A., and Miani, M. A., Health and disease management within an academic health system. Dis. Manage. Health Outcome. 7(1):21–37, 2000.

    MATH  Article  Google Scholar 

  36. 36.

    Akıncı, F., Coyne, J., Healey, B., and Minear, J., National performance measures for diabetes mellitus care: implications for health care providers. Dis. Manag. Health Outcome. 12(5):285–298, 2004.

    Article  Google Scholar 

  37. 37.

    Oleske, D. M., Epidemiology and the delivery of health care services methods and applications. Kluwer Academic/Plenum, NewYork, US, p. 350, 2002.

    Book  Google Scholar 

  38. 38.

    Protégé ontology editor by Stanford Center for Biomedical Informatics Research at the Stanford University School of Medicine. http://protege.stanford.edu/. Last accessed at: 23.11.2009.

  39. 39.

    Jegers, M., Kesteloot, K., Graeve, D. D., and Gilles, W., A typology for provider payment systems in health care. Health Policy.. (60):255–273, 2002.

  40. 40.

    OECD Reviews of Health Systems: Turkey, OECD Publications, France, 2008, pp. 141.

  41. 41.

    Campbell, B., Reerink, I., Jenniskens, F., and Pathak, L., A framework for developing reproductive health policies and programmes in Nepal. Reprod. Health Matt. 11(21):171–182, 2003.

    MATH  Article  Google Scholar 

  42. 42.

    Westert, G. P., van den Berg, M. J., Koolman, X., and Verkleij, H., Dutch Health Care Performance Report, Centre for Prevention and Health Services Research Public Health and Health Services Division, National Institute for Public Health and the Environment, 2008, pp. 240.

  43. 43.

    Hajialiafzali, H., Moss, J. R., and Mahmood, M. A., Efficiency measurement for hospitals owned by the Iranian Social Security Organisation. J. Med. Sys.. (31):166–172, 2007.

  44. 44.

    Ugurluoglu, O., and Celik, Y., How responsive Turkish Health Care System is to its citizens: the views of hospital managers. J. Med. Sys. 30:421–428, 2006.

    Article  Google Scholar 

  45. 45.

    Tung, Y., and Yang, M., How to effectively implement an indicator system to improve performance from a management perspective: the case of Taiwan Healthcare Indicator Series (THIS) System. J. Med. Syst.. (33):215–221, 2009.

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Correspondence to Oya D. Beyan.

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Beyan, O.D., Baykal, N. A Knowledge Based Search Tool for Performance Measures in Health Care Systems. J Med Syst 36, 201–221 (2012). https://doi.org/10.1007/s10916-010-9459-2

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Keywords

  • Performance measurement
  • Health care performance
  • Indicator search tool
  • Performance measurement ontology