Publication date: Jul 01, 2025
Aim This study investigates the adoption and implementation of clinical indicators in Japanese public hospitals, focusing on changes since the coronavirus disease 2019 (COVID-19) pandemic and utilizing Donabedian’s triadic model (structure, process, outcome). Methods A nationwide postal survey was conducted targeting 848 municipal hospitals with ≥20 beds in Japan. The survey explored clinical indicator usage, categorized by Donabedian’s framework. Hospitals were classified based on size to evaluate disparities in indicator adoption. Data were analyzed to compare findings from the 2024 survey with a similar 2016 survey. Questionnaires were mailed at the end of September 2024. Survey participants were provided with an extended deadline of December 16, 2024, which was one month after the original deadline. Results As of December 17, 2024, the response rate was 15. 7% (133 hospitals), with 130 valid responses. Clinical indicator adoption increased from 42. 4% (97) (2016) to 58. 5% (76) (2024). Large hospitals were more likely to implement clinical indicators (59 [88. 1%]) than small and medium hospitals (17 [27. 0%]). Frequently used indicators included average hospitalization duration, bed utilization rates, and clinical pathway coverage. Each structural indicator remained underutilized, with
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| Concepts | Keywords |
|---|---|
| Coronavirus | clinical indicators |
| Hospitals | clinical pathway |
| Japanese | hospital indicators |
| Pandemic | japan |
| medical quality |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 Pandemic |
| disease | IDO | process |
| pathway | REACTOME | Reproduction |
| disease | IDO | quality |