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Temporal Patterns in Hospital Performance Indicators in the Chilean Public Hospital System: A Longitudinal Analysis
José Rodríguez1,2, Manuel Vargas3, Pilar Cos2
1Facultad de Ciencias Económicas y Administrativas, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile.
Healthcare (Basel, Switzerland)
|July 28, 2026
Summary
Chilean public hospitals demonstrated stable performance indicator trends from 2019-2023 using dimensionless coefficients. This framework enables longitudinal comparisons across diverse institutions, highlighting consistent efficiency and mortality patterns.
Area of Science:
- Health Services Research
- Health Informatics
- Public Health Policy
Background:
- Hospital performance monitoring is crucial for healthcare system improvement.
- Comparing heterogeneous hospitals requires standardized metrics.
- Chile's public healthcare system faces challenges in performance evaluation.
Purpose of the Study:
- To analyze temporal trends in hospital performance indicators in Chile (2019-2023).
- To develop and apply dimensionless coefficients for comparing hospitals of varying sizes and case-mix.
- To assess the stability and predictability of hospital performance metrics.
Main Methods:
- Utilized data from 3,803,275 discharges across 68 Chilean public hospitals.
- Constructed dimensionless indicators: relative efficiency, severity, and mortality using DRG FONASA fields.
- Employed time-series analysis, coefficient of variation, outlier identification, and Random Forest (RF) predictive modeling.
Main Results:
- Most hospitals (95.6%) exhibited low within-hospital variability (CV < 0.5).
- Mean efficiency proxy increased from 0.3051 in 2019 to 0.3134 in 2023.
- Lagged relative efficiency proxy (REP) was the strongest predictor (85.1% variable importance); strong correlation (0.7857) with DEA model.
Conclusions:
- Dimensionless indicators revealed stable temporal patterns in Chilean public hospitals.
- The proposed framework supports longitudinal comparisons across heterogeneous institutions.
- External validation is recommended for broader applicability of the developed indicators.
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