Correlation analysis between single disease quality management and efficiency indicators of a tertiary hospital in China

Lan et al. BMC Health Services Research (2025) 25:1443 https://doi.org/10.1186/s12913-025-13619-3 BMC Health Services Research Open Access RESEARCH Correlation analysis between single disease quality management and efficiency indicators of a tertiary hospital in China Shuxiang Lan1†, Jianhong Guo1†, Huitong Chen1, Yanchong Jiang1 and Lingyu Zhang1* Abstract Background In the framework of continuous improvement of medical quality, specific (single) disease management has become a key priority. However, the current research on the correlation of various items for single disease management and efficiency indicators of hospitals is insufficient, and an in-depth discussion is urgently needed to optimize management strategies. Therefore, we explored the impact of single disease quality management based on its implementation upon single disease reporting rate, average length of stay (ALOS), and time consumption index (TCI) in clinical departments, to provide a reference for the management of improving hospital efficiency. Methods A single-center, repeated cross-sectional study was conducted across all clinical departments of Chaozhou Central Hospital. Data on the implementation of single disease quality management items, ALOS, and TCI were collected from clinical departments over the second half of 2024. The t-tests were used to compare the single disease reporting rates, ALOS, and TCI in different groups, and the correlation between the management items and the efficiency indicators was further analyzed by using multiple linear regression methods. Results In this study, the collected data from 174 management records showed that the single disease reporting rate, ALOS, and TCI were (85.330 ± 26.171)%, (7.657 ± 3.708) days, and (1.022 ± 0.246), respectively. Compared with the unqualified groups, the qualified groups in the disease catalog, data monitoring, scoring self-audit, system tracking, case tracking, effectiveness data, and training plans all showed increased single disease reporting rates with statistically significant differences (P < 0.05). The results of the multiple linear regression models showed that across the three models, the single disease reporting rate was negatively correlated with both ALOS (Beta= -4.882, 95% CI: -6.959 to -2.804) and TCI ( Beta= -0.382, 95% CI: -0.522 to -0.242), with statistically significant differences (P < 0.05). Meanwhile, the scoring self-audit was correlated with TCI ( Beta= -0.106, 95% CI: -0.193 to -0.018), and this correlation was also statistically significant (P < 0.05). Conclusions Our single-center study demonstrates that there were differences in single disease reporting rates resulting from different implementations of single disease quality management items. Improving single disease † Shuxiang Lan and Jianhong Guo contributed equally to this work. *Correspondence: Lingyu Zhang Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creati vecommons.org/licenses/by-nc-nd/4.0/. Lan et al. BMC Health Services Research (2025) 25:1443 Page 2 of 13 reporting rates contributed to reducing ALOS and TCI. Multi-center studies in other healthcare institutions are still needed to verify the association between single disease quality management and efficiency indicators. Keywords Medical quality management, Single disease quality management, Average length of stay, Time consumption index, Quality improvement Background Enhancing healthcare quality and efficiency is a core issue in the current field of healthcare [1]. Since 2009, China has begun to establish a National Specific (Single) Disease Monitoring System aimed at monitoring and improving the quality of healthcare for specific diseases [2]. Specific (single) disease quality management is a model of comprehensive quality control and management from all aspects of healthcare services for a specific single disease. In China, documents such as the Evaluation Standard for Tertiary Hospitals (2022 Edition / 2025 Edition) and the Single Disease Monitoring Information Items (2020 Edition) have guided healthcare institutions in implementing healthcare quality management. According to Donabedian’s quality of healthcare framework [3], which comprises structure, process, and outcome, structural factors - such as hospital- and department-level working groups, equipment like computer systems, and institutional procedures - play a crucial role in single disease quality management. Additionally, the Single Disease Monitoring Information Items (2020 Edition) contain a large number of process quality indicators and outcome quality indicators, which require focused attention on the interactions between the structure, process, and outcome dimensions. Based on the concept of lean healthcare [4, 5], single disease quality management can be defined as the integration of multiple processes, including diagnosis and treatment, post-discharge reporting, review by clinical departments, management activities of clinical departments, review by the department of medical quality management, reporting to the National Specific (Single) Disease Monitoring System, as well as audit and feedback by the department of medical quality management. This approach enables full employee participation in identifying and eliminating problems in single disease quality management. The implementation of single disease quality management can promote the rational utilization of medical resources and enhance hospitals’ service awareness [6]. Tertiary hospitals are capable of providing high-level specialized medical services [7]. Healthcare quality plays a critical role in evaluating the performance of these institutions [8]. Many hospitals are undergoing audits in areas such as efficiency, quality, and patient outcomes to improve their performance [9]. In modern hospital management, quality and efficiency are two key elements that are interrelated and mutually restrictive. In global health systems, measurable quality in (...truncated)