Healthcare institution efficiency: Meta-analysis and case study

The article analyses the factors that influence the efficiency of a medical institution. The VOSviewer bibliometric analysis allowed to identify four main clusters that determine the dominant areas of scientific research related to the topic of the medical institution efficiency. The largest cluster was the one describing the relationships between factors that directly determine the healthcare facility efficiency (decision-making, use of information technologies (artificial intelligence, blockchain, Internet of Things, etc.), effectiveness of solving medical problems of patients, etc.) The second largest cluster combines research areas related to the organisation, management, standardisation, audit, professional development, quality and productivity in healthcare facilities. The third and fourth clusters are related to the service and resource components in ensuring the efficiency of a medical institution, respectively. The article presents various approaches to classifying performance indicators of a medical institution: by type of performance, by form, by costs, by measurement of results, by scope of work, by stages. The national approaches to the medical industry development in the UK, Ukraine and Germany are analysed. The mechanisms for decentralising the management of medical institutions, increasing their autonomy, productivity and quality of medical services are described on the example of Ukraine. Using the pattern of a typical medical institution in a small city of Ukraine, the mechanisms for increasing efficiency are analysed: in terms of staffing, patient care, financing, corporate culture, patient-centeredness, and control over financial flows separately for each level of medical care. Priority steps to improve the infrastructure support of the subject of analysis, possible measures to improve the quality of medical services, the preferred resources for financing the planned measures, the implementation period and the expected results of proposed measures are identified. From the theoretical point of view, this article deepens knowledge about the nature of the medical institution efficiency. From a practical point of view, recommendations and ways to improve the medical institution efficiency make it possible to form a roadmap for promising changes. Their implementation will increase the primary healthcare facility efficiency and ensure a vivid rise in the medical provision efficiency at the secondary level in the short and medium term.