Exploring the Interplay Between Healthcare Quality and Economic Viability Through Massive Data Analysis-Driven...

Background: Hospital management increasingly requires integrating quality and economic performance metrics to ensure efficiency and sustainability. However, evidence on how hospital key performance indicators (KPIs) relate to financial outcomes remains scarce, particularly in private healthcare systems. Objective: To examine the relationships between hospital KPIs and two financial metrics-Sales and EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization)-in a Spanish private multi-hospital network. Methods: This retrospective, observational, multi-center study analyzed a final dataset of 47 standardized KPIs from 14 hospitals in the Vithas network. KPIs were examined using Self-Organizing Maps (SOM), an unsupervised neural network technique, to identify patterns and temporal dependencies with financial outcomes at contemporaneous, 3-month, and 6-month horizons. Robustness was evaluated through sensitivity analyses of model stability, data completeness, and clustering consistency. Results: The SOM analysis revealed six distinct clusters of KPIs, reflecting logical and interconnected behaviors. Sales and EBITDA were strongly associated with scheduled activity and space occupancy in the immediate term, while quality-related KPIs such as patient satisfaction and accessibility influenced financial outcomes at 3 and 6 months. These patterns suggest that selected KPIs can serve as predictive tools for financial performance. Conclusions: SOM proved effective for uncovering complex, nonlinear relationships between KPIs and financial metrics in hospital management. The study provides an operational framework linking standardized KPIs to financial outcomes in private hospitals, with implications for forecasting and strategic planning. Future research should incorporate additional KPIs, updated datasets, and SOM variants to validate and extend these findings across diverse healthcare systems.