@article{JHMHP10366,
author = {Jiaheng Wang and Chenrui Wang and Jing Li and Jiawei Huang and Sili Liu and Junpu Qin},
title = {A narrative review of time consumption index in diagnosis-related groups-based department efficiency evaluation},
journal = {Journal of Hospital Management and Health Policy},
volume = {10},
number = {0},
year = {2026},
keywords = {},
abstract = {Background and Objective: In the context of high-quality hospital development and the implementation of diagnosis-related groups (DRG), quantitative evaluation of medical service efficiency is critical. While the average length of stay (ALOS) is a traditional metric, it lacks standardization across disease difficulties. The time consumption index (TCI) enabled comparison between disease severity and resource consumption. This review aims to synthesize the research progress of TCI, moving beyond theoretical associations to provide a cohesive framework for optimizing departmental efficiency.Methods: A systematic literature search was conducted in CNKI (China National Knowledge Infrastructure) and PubMed databases for studies published up to July 31, 2025. Using keywords including “Time Consumption Index”, “DRG”, and “departmental efficiency”, we screened 510 records and ultimately included 57 high-quality studies (45 Chinese and 12 English). The review analyzed the definition, calculation, correlated factors, and practical applications of TCI.Key Content and Findings: The literature reveals that TCI serves as a core lever for economic control and resource allocation under the DRG payment system. Unlike isolated ALOS metrics, TCI reflects operational efficiency, with values 1 suggesting potential workflow bottlenecks or unobserved severity. Key findings indicate that TCI is driven not only by patient factors but significantly by process-level drivers, specifically preoperative hospitalization duration and initial test waiting times. In practical application, hospitals have successfully reduced TCI by implementing pre-hospitalization policies—completing examinations before admission—and optimizing interdepartmental coordination, rather than blindly shortening stay duration.Conclusions: TCI is an essential tool for balancing medical quality and operational efficiency. To reasonably transition towards higher efficiency, hospitals must shift focus from passive monitoring to active process re-engineering. Future improvements should prioritize optimizing admission workflows and ensuring the data quality of medical record. These strategies will guide hospitals in reducing marginal costs and enhancing service throughput without compromising patient safety.},
issn = {2523-2533}, url = {https://jhmhp.amegroups.org/article/view/10366}
}