Healthcare supply chain risk assessment KPIs: an empirical study using PLS-SEM

Senna, Pedro; Reis, Augusto; Guimarães, Julio de; Marujo, Lino Guimarães; Santos, Ana Carla de Souza Gomes dos; Severo, Eliana Andrea

doi:10.1590/0103-6513.20220107

Brasil

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Research Article • Prod. 33 • 2023 • https://doi.org/10.1590/0103-6513.20220107 linkcopy

Healthcare supply chain risk assessment KPIs: an empirical study using PLS-SEM

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Paper aims This study has the objective of mapping and empirically validating KPIs that can be used to assess healthcare supply chain risks.

Originality We combined two methodological approaches: i) we conducted a systematic literature review to identify the healthcare supply chain risk assessment KPIs and ii) We grouped these KPIs into five constructs and validated their relations using PLS-SEM.

Research method This is the only study that presents a systematic literature review to identify KPIs that measure healthcare supply chain risks, groups the KPIs into a theoretical framework, and presents a PLS-SEM validation. This study used data from Brazil, from a variety of healthcare supply chain organizations (suppliers, OEMs, clinics, and hospitals), therefore we cannot guarantee that the study can be generalized.

Main findings The systematic literature review identified 27 KPIs which were grouped into five constructs. The structural model supported by the PLS-SEM technique revealed that reliability, responsiveness, costs, and agility are antecedents to healthcare supply chain quality.

Implications for theory and practice Managers may rely upon this study to understand that healthcare supply chain reliability and responsiveness are antecedents to healthcare supply chain costs and agility, which are antecedents to healthcare supply chain quality.

Keywords KPI; Healthcare supply chain risk management; Supply chain resilience; PLS-SEM

	Ocurrences
Strings	SCOPUS	Web of Science
“SUPPLY CHAIN” AND “RISK” AND “INDICATOR”	261	68
“LEAN HEALTHCARE” AND “INDICATOR”	5	1
“SUPPLY CHAIN RISK MANAGEMENT” AND “INDICATOR”	18	2
“SUPPLY CHAIN RESILIENCE” AND “INDICATOR”	13	4
“SUPPLY CHAIN RISK MANAGEMENT” AND “HEALTHCARE”	0	0
“SUPPLY CHAIN RESILIENCE” AND “HEALTHCARE”	1	1
“HEALTHCARE” AND “LEAN INDICATOR”	0	0
“SUPPLY CHAIN RISK MANAGEMENT” AND “KPI”	0	1
Total	298	77

Construct	Variable	Reference
Reliability	REL1 - Bed ocupancy	Gu & Itoh (2016)
	REL2 - Monthly number of inpatients	Gu & Itoh (2016)
	REL3 - Monthly number of outpatients	Gu & Itoh (2016)
	REL4 - More visited diagnosis centers (visited by the patients)	Gu & Itoh (2016)
	REL5 - Number of operations procedures	Experts
	REL6 - Outpatient waiting time	Gu & Itoh (2016)
	REL7 - Wait time in ER/clinic	Gu & Itoh (2016); Günal & Pidd (2011)
Costs	COS1 - General costs	Gu & Itoh (2016); Reijula et al. (2014), Robinson et al. (2012); Díaz et al. (2012),
	COS2 - Human Resources Costs	Li et al. (2015); VanVactor (2011); Khalili et al. (2016); Gu & Itoh (2016); Reijula et al. (2014); Sedevich-Fons (2014); Díaz et al. (2012)
	COS3 - Inventory Costs	Experts
	COS4 - Maintenance repair costs per m²	VanVactor (2011); Zepeda et al. (2016); Díaz et al. (2012)
	COS5 - Mitigation costs	SCOR 12.0
Quality	QUA1 - Quality: Improvement initiatives and innovation	SCOR 12.0
	QUA2 - Supply Availability	Minami et al. (2016); Gu & Itoh (2016); Habidin et al. (2015); Yildiz & Demirors (2014); McIntosh et al. (2014); Aoun & Hasnan (2013)
	QUA3 - On time delivery	McIntosh et al. (2014); Aoun & Hasnan (2013)
	QUA4 - Investments	Habidin et al. (2015)
	QUA5 - Maintenance efficiency	McIntosh et al. (2014); Aoun & Hasnan (2013)
	QUA6 - Continuous Education	Shohet (2006)
Responsiveness	RES1 - Contract approval and issue time - personnel	Crema & Verbano (2015); Cavalcante et al. (2016); Minami et al. (2016); Efe & Efe (2016); Hammadi et al. (2015)
	RES2 - Contract approval and issue time - materials	Rajesh (2016), Experts
	RES3 - Environmental impact	Rajesh (2016), Experts
	RES4 - Order Fullfillment	Kolotzek et al. (2018)
	RES5 - Order compliance	SCOR 12.0
Agility	AGI1 - Employees error rate	Rajesh (2016)
	AGI2 - Amount of Debt	Li et al. (2015); Gu & Itoh (2016); Reijula et al. (2014); Rajesh (2016)
	AGI3 - Overtime	Gu & Itoh (2016)
	AGI4 - Paid leave	Gu & Itoh (2016)

Reliability (REL)	Factorial loads	Communality	Mean
REL1 - Bed ocupancy	0.850	0.803	4.235	0.990
REL2 - Monthly number of inpatients	0.820	0.743	4.226	1.007
REL3 - Monthly number of outpatients	0.730	0.651	4.047	1.054
REL4 - More visited diagnosis centers (visited by the patients)	0.880	0.779	4.216	0.975
REL5 - Number of operations procedures	0.890	0.882	4.396	0.922
REL6 - Outpatient waiting time	0.750	0.733	3.962	1.137
REL7 - Wait time in ER/clinic	0.770	0.693	4.188	0.996
Mean 4.182; Standard deviation 1.012; Cronbach's alpha 0.910; Composite reliability 0.933; KMO 0.847
Costs (COS)
COS1 - General costs	0.870	0.789	4.075	1.020
COS2 - Human Resources Costs	0.860	0.732	4.056	1.012
COS3 - Inventory Costs	0.880	0.796	4.169	0.909
COS4 - Maintenance repair costs per m²	0.850	0.747	3.971	0.940
COS5 - Mitigation costs	0.850	0.697	4.113	0.908
Mean 4.077; Standard deviation 0.958; Cronbach's alpha 0.932; Composite reliability 0.934; KMO 0.871
Quality (QUA)
QUA1 - Quality: Improvement initiatives and innovation	0.690	0.534	4.301	0.863
QUA2 - Supply Availability	0.830	0.800	4.292	1.013
QUA3 - On time delivery	0.780	0.669	4.245	1.002
QUA4 - Investments	0.830	0.775	4.226	1.026
QUA5 - Maintenance efficiency	0.870	0.859	4.207	1.092
QUA6 - Continuous Education	0.650	0.555	4.349	0.915
Mean 4.270; Standard deviation 0.986; Cronbach's alpha 0.918; Composite reliability 0.898; KMO 0.878
Resilience (RES)
RES1 - Contract approval and issue time - personnel	0.790	0.848	4.047	0.898
RES2 - Contract approval and issue time - materials	0.890	0.842	4.047	0.919
RES3 - Environmental impact	0.610	0.336	4.028	1.081
RES4 - Order Fullfillment	0.520	0.575	4.075	0.847
RES5 - Order compliance	0.630	0.585	4.150	0.881
Mean 4.070; Standard deviation 0.925; Cronbach's alpha 0.910; Composite reliability 0.822; KMO 0.763
Agility (AGI)
AGI1 - Quality: Employees error rate	0.700	0.507	3.933	1.197
AGI2 - Amount of Debt	0.750	0.566	3.915	1.096
AGI3 - Overtime	0.710	0.648	3.952	0.950
AGI4 - Paid leave	0.740	0.701	3.849	1.136
Mean 3.913; Standard deviation 1.095; Cronbach's alpha 0.851; Composite reliability 0.814; KMO 0.778

	REL	COS	QUA	RES	AGI
REL	0.792^a a Square root of Average Variance Extracted (AVE) – Convergent Validity (CV).
COS	0.594^b	0.752^a
QUA	0.518^b b Correlation between constructs – Discriminant Validity (DV).	0.646^b	0.857^a
RES	0.560^b	0.571^b	0.640^b	0.773^a
AGI	0.510^b	0.677^b	0.638^b	0.490^b	0.807^a

	Loading	Hypotheses
H1a - REL → COS	0.510^* * p<0.05.	supported
H1b - REL → AGI	0.470*	supported
H2a - RES → COS	0.374*	supported
H2b - RES → AGI	0.362*	supported
H3 - COS→ QUA	0.475*	supported
H4 - AGI → QUA	0.330*	supported

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[1] KMO: Kaiser-Meyer-Olkin.