Propuesta de indicadores para cuadros de mando de servicios médicos y quirúrgicos.

Astier MP, de Val Pardo I, Gost Garde J, et al. Propuesta de indicadores para cuadros de mando de servicios médicos y quirúrgicos. Rev Adm Sanit. 2004;2(3):485-507 Short Summary This study aimed to develop and validate two consensus-based balanced scorecard models for medical and surgical hospital services within the Spanish public health system. Recognizing the growing role of clinical service heads in management and accountability, the authors sought to define a practical set of activity, quality, and economic indicators to support cost-effective decision-making. Using a two-round Delphi methodology, questionnaires containing 94 indicators for medical services and 108 for surgical services were distributed to over 2,400 heads of clinical units across Spanish public hospitals. Indicators were grouped into three domains: (1) resources and activity, (2) quality, and (3) resource consumption and expenditure. Following consensus (≥50% agreement), the proposed models were reduced to 46 indicators for medical services and 53 for surgical services—approximately a 50% reduction from the original proposals. Activity and structural indicators were most retained, while financial indicators were more frequently excluded. Respondents preferred tabular presentation and comparison with previous-year data. Despite a low response rate, the study provides one of the first structured, consensus-based proposals for service-level balanced scorecards in Spanish hospitals, supporting the integration of clinical management, quality monitoring, and resource accountability.