Characteristics of Medical Quality in Tertiary Traditional Chinese Medicine Hospitals by TOPSIS and RSR Methods

Abstract

Performance evaluation is important for improving medical quality and services. But, there is a lack of research for medical quality in traditional Chinese medicine (TCM) hospitals. This study examines the medical quality and various indicators of tertiary public traditional Chinese medicine hospitals in Gansu Province, to establish a foundation for improving the medical and management standards of these hospitals. This study collected performance assessment data from 10 tertiary TCM hospitals in Gansu Province from 2019 to 2022. Thirteen indicators with TCM characteristics were selected and categorized into 3 aspects: control of medical costs, internal operational dimensions, and comprehensive management. The level of medical quality in different hospitals and in different years were determined using the TOPSIS method for ranking and the RSR method for grading. Firstly, in terms of TCM characteristic indicators, hospital H had the highest control of medical costs and comprehensive management among different hospitals, with 45.87% and 24.20% respectively. The highest values for control of medical costs and comprehensive management were observed in 2020, with 40.65% and 18.69% respectively among different years. When evaluating the medical quality of different hospitals using the TOPSIS method, it was found that hospital H had the highest ranking from 2020 to 2022, with C_i values of 0.725, 0.778, and 0.667 respectively. Additionally, the RSR method indicated that hospital H had a high level of grading from 2020 to 2022, with P_i values of 0.687, 0.690, and 0.723 respectively. These findings suggest that the medical quality of hospital H is at a high and stable level of development. Based on the TOPSIS method to evaluate the performance appraisal results and ranking of different hospitals from 2019 to 2022. The results showed that the highest ranking was hospital B(C_i = 0.913) in 2019. The highest ranking was hospital C(C_i = 0.809)in 2020. The highest ranking was hospital D(C_i = 0.689) in 2021. The highest ranking was hospital J(C_i = 0.865) in 2022. The RSR method indicated that high grading level were hospitals B(P_i = 0.899),F(P_i = 0.795) in 2019. The highest grading level was hospital C(P_i = 0.809) in 2020. The highest grading level were hospitals A(P_i = 0.868), D(P_i = 0.813), E(P_i = 0.689), G(P_i = 0.873), J(P_i = 0.813), K(P_i = 0.842) in 2022. Based on the above results indicate that there is a large variation in the medical quality profile of different hospitals from 2019 to 2022. By comparing the results of TOPSIS and RSR method from 2019 to 2022, we found that the hospitals with identical ranking were D and J, and the hospitals with ≤2 difference in ranking was A,B,C,E in 2019, the hospitals with >2 ranking was A, F in 2020, the hospitals with >2 ranking were C, G in 2021, and the hospitals with identical ranking results were B,D,E,G,J in 2022. Comparing the ranking results of TOPSIS and RSR methods, showed that the hospitals with identical rankings were B, F from 2019 to 2022. The difference in ranking results ≤2 were A, C, D, E, G, H, J, K, indicating that high consistency between TOPSIS and RSR methods and credible results. The findings reveal significant fluctuations in medical quality across different years, while the overall level of medical quality remains relatively stable among the various hospitals. It is recommended that TCM hospitals focus on improving management efficiency, optimizing hospital operations, enhancing the utilization of medical resources, and fostering the efficient development of hospitals.

Keywords: RSR method; TOPSIS method; Traditional Chinese Medical Hospitals; medical quality; performance appraisal.

Figure 1.

Comparison of differences in TOPSIS and RSR Methods Across Hospitals and Years. (A) Ranking of different hospitals by TOPSIS method, (B) Grading of different hospitals by RSR method, (C) Ranking of hospitals by using TOPSIS method from 2019 to 2022, (D) Grading of hospitals by using RSR method from 2019 to 2022.