Hospital quality indicator weighting using Analytical Hierarchy Process (AHP) method
Abstract
Hospital quality measurement systems frequently lack appropriate weighting among indicators, limiting their capacity to represent actual performance outcomes and to support evidence-based policy prioritization. Developing a composite index with empirically derived weights is therefore essential to enhance the precision and practical utility of hospital quality assessments. An integrated approach is needed to combine various indicators into a single aggregate measure which can serve as a comprehensive tool for assessing hospital performance, facilitating evidence-based evaluation, and enabling continuous monitoring of quality improvement over time. This study aimed to determine the relative importance of hospital quality indicators for constructing a composite quality index using the Analytical Hierarchy Process (AHP). The AHP method allows structured quantification of expert judgments through systematic pairwise comparisons across multiple dimensions of hospital quality. A quantitative analytical observational study with a cross-sectional design was conducted at teaching hospital as a preliminary investigation. Eight core indicators were identified from INM, IMPRS, and IKM datasets (2018–2023) using Confirmatory Composite Analysis (CCA). The AHP method was then applied to assess the relative weighting of each indicator based on expert input. AHP analysis indicated that hand-hygiene compliance and emergency cesarean-section response time were the two with the highest weight indicators, followed by compliance with clinical pathways and medical-record documentation completeness. These results emphasize that hospital quality not only formed from one element, but combination of many which are elements of safety, timeliness, critical effectiveness and process reliability. The resulting weighted hierarchy provides a structured, evidence-based foundation for developing a hospital quality composite index and offers policymakers a reliable tool to evaluate and enhance hospital performance.