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Governmental Investments in Hospital Infrastructure Among Regions and Its Efficiency in China: An Assessment of Building Construction

ABSTRACT: Hospital infrastructure has been addressed as the prerequisite of healthcare delivery which intensively affects medical quality. Over the past decade, China has proposed a series of investment plans for hospital infrastructure in order to promote healthcare development in underdeveloped regions. Focusing on the construction of hospital buildings as the key component of hospital infrastructure, this study aims to examine whether the investment efficiency is lower where a government prioritizes equity and to explore what kind of geographical predispositions should be embedded in governmental investment plans for hospital infrastructures from the perspectives of both investment equity and efficiency. Relevant data from 330 governmental-invested hospital building construction projects in Sichuan province, China, from 2009 to 2018 were collected. Concentration index was used to evaluate the equity in the distribution of the investments. Tobit model was employed to explore the relationship between regional economic development and investment efficiency measured by an integrated approach of principal component analysis and data envelopment analysis. The results demonstrated a slight concentration of governmental investments in economically developed regions, while a negative association with regional economic development was identified with investment efficiency. Our study illustrated the investment efficiency was higher where a government prioritized equity and provided empirical evidences on switching governmental investment predisposition in the aspect of healthcare infrastructure construction toward less developed regions in China from the perspectives of both investment allocation equity and efficiency, which would further assist in the formulation of region-specific policies and strategies for underdeveloped regions.

SUBMITTER: Lan T

PROVIDER: S-EPMC8564047 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Digital transformation in health care is being driven by the need to improve quality, reduce costs, and enhance the patient experience of health care delivery. It does this through both the direct intervention of technology to create new diagnostic and treatment opportunities and also through the improved use of information to create more engaging and efficient care processes. OBJECTIVE:In a modern digital hospital, improved clinical and business processes are often driven through enhancing the information flows that support them. To understand an organization's ability to transform their information flows requires a clear understanding of the capabilities of an organization's information technology infrastructure. To date, hospital facilities have been challenged by the absence of uniform ways of describing this infrastructure that would enable them to benchmark where they are and create a vision of where they would like to be. While there is an industry assessment measure for electronic medical record (EMR) adoption using the Healthcare Information and Management Systems Society Analytics EMR Adoption Model, there is no equivalent for assessing the infrastructure and associated technology capabilities for digital hospitals. Our aim is to fill this gap, as hospital administrators and clinicians need to know how and why to invest in information infrastructure to support health information technology that benefits patient safety and care. METHODS:Based on an operational framework for the Capability Maturity Model, devised specifically for health care, we applied information use characteristics to define eight information systems maturity levels and associated technology infrastructure capabilities. These levels are mapped to user experiences to create a linkage between technology infrastructure and experience outcomes. Subsequently, specific technology capabilities are deconstructed to identify the technology features required to meet each maturity level. RESULTS:The resulting assessment framework clearly defines 164 individual capabilities across the five technology domains and eight maturity levels for hospital infrastructure. These level-dependent capabilities characterize the ability of the hospital's information infrastructure to support the business of digital hospitals including clinical and administrative requirements. Further, it allows the addition of a scoring calculation for each capability, domain, and the overall infrastructure, and it identifies critical requirements to meet each of the maturity levels. CONCLUSIONS:This new Infrastructure Maturity Assessment framework will allow digital hospitals to assess the maturity of their infrastructure in terms of their digital transformation aligning to business outcomes and supporting the desired level of clinical and operational competency. It provides the ability to establish an international benchmark of hospital infrastructure performance, while identifying weaknesses in current infrastructure capability. Further, it provides a business case justification through increased functionality and a roadmap for subsequent digital transformation while moving from one maturity level to the next. As such, this framework will encourage and guide information-driven, digital transformation in health care.

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Governmental Investments in Hospital Infrastructure Among Regions and Its Efficiency in China: An Assessment of Building Construction

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