45 The Association between eHealth Capabilities and the Quality and Safety of Health Care delivered in Dutch hospitals lasts, these are the best available data at this moment. Comparable reports are published, discussed and disputed in other countries.14–16 The scores of Elsevier are, as opposed to other reports in the Netherlands, based upon publicly available indicators and based upon a scientific method to construct composite indicators.17 This method has been prepared jointly by the OECD and the Applied Statistics and Econometrics Unit of the Joint Research Centre of the European Commission in Ispra, Italy. The scores of the Elsevier publication (Fig. 1) are based upon 542 of the 1516 publicly available indicators from the above-mentioned datasets (IGZ and ZIZO). Fig. 1 Structure of Elsevier scores based upon 542 indicators of publicity available hospital wide indicator sets Almost all indicators from the hospital-wide indicator sets are included in the abovementioned selection and a large portion of indicators for acute care. Some acute care is only delivered by specialized hospitals and cannot be used to compare all hospitals. Only those indicators for acute care are included that are delivered by all hospitals like infectious diseases, cardiovascular diseases and the surgical process. No indicators were selected for which a case mix correction is still necessary. In this study, the different indicators are combined into compound indicators. The annual reports have been collected and analyzed by ‘SiRM - Strategies in Regulated Markets’, a consultancy firm in The Hague. The indicators are first scaled to a uniform scale (z-score) and are then added together weighted. Hospitals that have not submitted data are given the scored lowest value. Hospitals could correct possible erroneous values: 68 hospitals have sent SIRM updates of their values. Care-related indicators are divided into the domains of ‘effectiveness’, ‘patient orientation’ and ‘safety’ (Fig. 1). The scores in these three domains, together with waiting lists, determine the position of the hospital in the Elsevier study on ‘The Best Hospitals’. The scores on the domains of ‘safety’ and ‘effectiveness’ are bundled in a score for ‘medical care’. The scores on 3
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