The Impact of JCI Accreditation on the Clinical, Operational, and Financial Performance of Chinese Private Hospitals

Author(s): HongFan Zhang, Mark J Bittle, HerngChia Chiu, Leiyu Shi, Siou-Tang Huang

Background: Joint Commission International (JCI) accreditation is well known as an international healthcare services organization accreditation body focused on improving the quality of healthcare and patient safety. Over 90% of JCI-accredited hospitals in China are private hospitals. Our study is the first to examine JCI accreditation's impact on Chinese private hospitals. The study objective was to assess the association between JCI accreditation and clinical, operational, and financial performance measures.

Methods: We used the multiple-group interrupted time series analysis (ITSA) to compare intervention Hospital A and comparison Hospital B in terms of eight performance measures based on monthly observations over eight years from January 2015 to December 2022. The clinical quality measures used were the C-section rate, perineal incision rate, the incidence of macrosomia, and the preterm birth rate. The operational performance indicators were the number of outpatient visits and the number of deliveries. The financial performance measures were revenue and earnings before interest, tax, depreciation & amortization (EBITDA).

Results: P value of <0.05 was used for statistical significance. The regression analysis indicated that JCI accreditation is significantly associated with the C-section rate, the number of outpatient visits, the number of deliveries, and revenue. However, JCI accreditation had no statistically significant association with the other three clinical measures, namely, the perineal incision rate, incidence of macrosomia, and preterm birth rate. No evidence demonstrated that JCI accreditation is statistically associated with EBITDA.

Conclusions: This is the first study to evaluate the impact of JCI accreditation on select clinical, operational, and financial performance measures in Chinese private hospitals, which account for over 90% of all JCI-accredited hospitals in China. JCI accreditation is significantly associated with decreasing C-section rates and increasing revenue, outpatient visits, and deliveries. The associated external assessment promotes the continuous improvement of care quality and patient safety. Hospital management may use JCI accreditation as a management tool to drive integration, collaboration, and constant improvement.