OBJECTIVES: To evaluate the factors that explain why public hospitals subjected to the financial pressure of the market economy may have difficulties in maintaining the quality of care for the population in their area of influence and obtain worse results than those with better economic capacity

METHODS: This cross-sectional study investigated the financial situation and quality of health care delivery in public hospitals located in the department of Atlántico, Colombia. Financial, health care quality, and productivity data were taken from the Hospital Information System (SIHO) and subsequently used to develop a financial performance composite score using principal components analysis (PCA). The correlation between the financial performance composite score and the quality/safety performance composite score was calculated using linear regression adjusted for the characteristics of each hospital.

RESULTS: Among the 28 public hospitals in the department of Atlántico (Colombia) for which data were available, there is a clear relationship between their financial performance and the quality of patient care (Parameter: 4.439; p-value: 0.039). However, no association could be demonstrated between a better financial situation of hospitals with their Real Value Units (RVU) equivalent productivity score (Parameter: 0.547; p-value: 0.462)

CONCLUSIONS: Reducing the costs of care by affecting the revenue budget of public hospitals could jeopardize the quality of care they provide to vulnerable populations. The low predictive validity may explain why previous studies on the association between finances and quality have obtained inconclusive results.